以指骨固定夾板固定指骨閉鎖性骨折癒合之探討

Discussion on the bone healing of phalangeal closed fracture with phalanx fixed splint

劉郁辰(Yu-Chen Liu)

指導教授 ： 田育彰

高雄醫學大學/健康科學院/醫學影像暨放射科學系碩士在職專班/碩士(2018年)

摘要

手指的精細動作控制在我們日常生活中扮演相當重要的角色。因為關節的活動度，能使拇指與另四根手指頭交互運動，進而可以做出精準的抓取或對掌動作。指骨與掌骨骨折約占所有骨折的10%，而指骨骨折一般處理的方式有骨釘、骨板、外固定器及副木。其中常發生的問題是在骨折癒合後，若有發生關節僵硬，會使關節活動度受到限制，造成生活機能的不便；理想的固定方式，在於能儘可能開始早期復健療程，且又能提供合適的固定性，以避免在復健過程中造成骨折移位的併發症，延長癒合時間。
本研究在探討受檢者與指骨骨折骨癒合程度之相關因素。以2016年至2017年在南部某西醫診所骨科門診就診之手部指骨骨折患者，且以指骨固定夾板固定治療追蹤三個月為研究樣本，共收集40人。資料收集包括︰病歷資料、X光攝影檢查報告及關節活動角度；統計分析方式則採用T檢定測試其統計顯著性，分析其相關性。經由研究之結果顯示了︰(1)骨折癒合程度在治療前後的骨痂面積有顯著相關(p<0.05)。(2)若以50歲作為切點下，在骨痂形成的面積差異，結果有顯著意義(p=0.049)。(3)40例手指骨折患者中有35例癒合良好，癒合良好率為87%。

關鍵字

X光攝影 ； 指骨骨折 ； 固定夾板

並列摘要

The finger function plays an important role in our daily life.The finger executes accurately opposition and grasping through the joint activities. Fractures of phalanges and metacarpals account for 10% of all bone fractures. Bone screw and plates, external fixators, and splints are used in the general treatment of phalangeal fractures. Ankylosis is the major problem of the bone healing on the proximal interphalangeal joint. The motion of the joint will be limited, resulting in inconvenience in life function; so the ideal fixation is to start the early rehabilitation as soon as possible. Appropriate fixation to avoid complications of fracture displacement during rehabilitation. Otherwise it will prolong the fracture healing time.Our study explored the factors related to the degree of bone healing in the fractures of the phalanges. Forty patients with fractures of the phalanges were enrolled in a western medicine clinic, case-control study from 2016 to 2017, and used a splint immobilization for three months as study sample. Data collection includes: medical records, radiographs, and range of motion; statistical analysis uses T-tests to test their statistical significance and analyze their relevance.
In our study, we found the healing of fracture callus before and after treatment with a significant correlation (p<0.05), and after age adjustment, the age of fifty as the cut-off point, the formation of bone callus of significant difference (p= 0.049).Finally,forty patients of finger fractures were healed in thirty-five, and the healing rate was 87%.

並列關鍵字

X-ray photography ； phalangeal fracture ； fixed splint

參考文獻

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