克氏针内固定联合早期功能锻炼在手多发性骨关节创伤患者的应用效果观察

尹世海??史清梅??万传俊??胡明龙

[摘要] 目的 观察克氏针内固定联合早期功能锻炼在手多发性骨关节创伤患者中的临床治疗效果。 方法 选取2015年5月～2016年8月我院收治手多发性骨关节创伤患者23例，入院后完善相关检查，均给予克氏针内固定联合早期康复锻炼治疗，采用生活质量评估量表对患者治疗前、后生活质量情况进行评估，比较患者治疗前、后临床效果。 结果 23例患者采用克氏针内固定联合早期功能锻炼后均取得治疗成功，克氏针固定未出现脱出，患者治疗4.5～7周去除克氏针。治疗后对患者进行12个月随访未见感染，恢复良好。治疗后入选23例患者躯体功能、角色功能、认知功能、情绪功能、社会功能、整体功能评分高于治疗前（P<0.05）。 结论 手多发性骨关节创伤患者采用克氏针内固定联合早期功能锻炼效果理想，能提高患者生活质量，值得推广应用。

[关键词] 克氏针内固定；手多发性骨关节创伤；治疗效果

[中图分类号] R687.3 [文献标识码] A [文章编号] 2095-0616（2017）12-175-03

Application effect observation of Kirschner wire internal fixation combined with early functional exercise on multiple traumatic bone and joint injuries in hand

YIN Shihai SHI Qingmei WAN Chuanjun HU Minglong

Department of Hand Surgery，Liaobu Hospital of Guangdong Medical University，Dongguan 523400，China

[Abstract] Objective To observe the clinical effect of Kirschner wire internal fixation combined with early functional exercise in patients with multiple osteoarticular trauma. Methods 23 patients with traumatic multiple osteoarticular trauma in our hospital from May 2015 to August 2016 were selected.All the patients were treated with Kirschner wire fixation combined with early rehabilitative exercise.The quality of life before and after treatment was evaluated by the quality of life scale.The clinical effect before and after treatment was compared. Results All the patients were successfully treated with Kirschner wire fixation and early functional exercise.The Kirschner wire fixation did not appear.The patients were treated with Kirschner wire for 4.5-7 weeks.After treatment，patients were followed up for 12 months without infection，the recovery was good.The scores of physical function，role function，cognitive function，emotional function，social function and overall function of 23 patients were higher than those before treatment （P<0.05）. Conclusion Kirschner internal fixation combined with early functional exercise is ideal for the patients with multiple traumatic bone and joint injuries.It can improve the quality of life of patients，and it is worthy of popularization and application.

[Key words] Kirschner wire fixation；Multiple trauma of the hand；Treatment effect

多發性骨关节创伤是临床上常见的疾病，是指两处以上骨关节损伤，临床上表现为严重的多发性损伤，患者多由外部暴力引起，而手多发性骨关节创伤主要是指创伤位于手术，患者发病后如果得不到及时有效的治疗，将会影响患者生活质量[1]。但是，由于手部多发伤疾病复杂，部分患者伴有粉碎性或多发骨折，增加治疗难度。文献报道显示：将克氏针内固定联合早期功能锻炼运用于手多发性骨关节创伤中效果理想，能促进骨折创伤部位愈合，但是该结论尚未得到进一步证实[2]。为了探讨克氏针内固定联合早期功能锻炼在手多发性骨关节创伤患者中的临床治疗效果。……