目的:本研究比较了短臂石膏夹板(SAPS)与动态掌骨稳定夹板(DMSS)治疗第五掌骨颈骨折的临床和影像学结果。
方法:119例患者于2018年至2019年间转诊至我们的研究所,并在适当的初始闭合复位后接受SAPS或DMSS治疗。在治疗后第10天和第20天以及第1、2和3个月进行随访检查。对齐骨折,运动范围(ROM),并在每次访视期间评估并发症.使用测力计评估握力。自我保健,日常活动,疼痛/不适,使用EuroQol5维5级(EQ-5D-5L)和VAS评估焦虑/抑郁。
结果:在119名患者中,103完成了所有后续检查。总的来说,51例患者接受SAPS治疗,52例患者接受DMSS治疗。在DMSS组的5例患者中检测到皮肤病变,但在SAPS组中没有(p=0.008)。DMSS组患者的握力在1-,2个月和3个月随访(p<0.001)。在1个月的随访中,DMSS组的指间关节和掌指关节的ROM在统计学上更好(p<0.001),但在3个月的随访中相似(p=0.27)。在3个月的随访中,DMSS组的腕部ROM在统计学上较高(p<0.05)。自我保健,日常活动,疼痛/不适,在所有随访中,DMSS组的焦虑/抑郁在统计学上更好(p<0.05),由EQ-5D-5L测定。
结论:使用DMSS对稳定的拳击手骨折的动态稳定与使用SAPS的静态稳定一样有效,可以保持复位并确保愈合。然而,DMSS提供更好的早期ROM,comfort,和肌肉力量,尽管偶尔发生皮肤病变,但较早恢复日常活动。
OBJECTIVE: This
study compared the clinical and radiological results of fifth metacarpal neck fractures treated with a short-arm plaster splint (SAPS) versus a dynamic metacarpal stabilization splint (DMSS).
METHODS: The 119 patients were referred to our institute between 2018 and 2019 and treated with SAPS or DMSS after appropriate initial closed reduction. Follow-up examinations were conducted at days 10 and 20, and at 1, 2, and 3 months after treatment. Alignment of the fracture, range of motion (ROM), and complications were evaluated during each visit. Grip strength was evaluated using a dynamometer. Self-care, usual daily activities, pain/discomfort, and anxiety/depression were evaluated using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) and a VAS.
RESULTS: Of the 119 patients, 103 completed all follow up examinations. In total, 51 patients were treated with SAPS and 52 with DMSS. Skin lesions were detected in five patients in the DMSS group, but none in the SAPS group (p = 0.008). The grip strength of patients in the DMSS group was statistically better at the 1-, 2-month and 3-month follow-up visits (p < 0.001). ROM of the interphalangeal and metacarpophalangeal joints were statistically better in the DMSS group at the 1-month visit (p < 0.001) but similar at the 3-month visit (p = 0.27). Wrist ROM was statistically higher in the DMSS group at the 3-month visit (p < 0.05). Self-care, usual daily activities, pain/discomfort, and anxiety/depression were statistically better in the DMSS group at all follow-up visits (p < 0.05), as determined by the EQ-5D-5L.
CONCLUSIONS: Dynamic stabilization of a stable boxer\'s fracture with DMSS is as effective as static stabilization with SAPS for maintaining the reduction and ensuring union. However, DMSS provides better early ROM, comfort, and muscle strength, as well as an earlier return to usual daily activities despite the occasional skin lesions happened.