目的探索微型支架联合手部多功能支具防治虎口挛缩的临床效果。方法选取2013年2月至2014年10月急诊手部虎口损伤患者42例,按治疗方式随机分成4组:支架+支具治疗组、支架治疗组、支具治疗组、常规治疗组。各组治疗后随访16周,观察并记录患者虎口宽度及虎口角数据,通过统计学分析对比各方案的优越性。结果①支架+支具治疗组、支架治疗组、支具治疗组、常规治疗组术后16周虎口宽度分别增大(24.1±5.8)mm、(9.6±4.6)mm、(15.8±1.9)mm、(4.0±5.4)mm,各组两两比较差异均有统计学意义(P<0.05)。②支架+支具治疗组、支架治疗组、支具治疗组、常规治疗组术后16周虎口角分别增大(23.5±6.1)°、(9.6±4.6)°、(15.7±1.9)°、(3.9±5.4)°,各组两两比较差异均有统计学意义(P<0.05)。③除1例支架针孔感染,经换药后治愈,其他患者未见明显不良反应。结论微型支架联合手部多功能支具应用于防治虎口挛缩治疗,能有效增大虎口宽度及虎口角,不良反应少,值得推广应用。

Objective To explore the clinical effect of miniature stent combining hand orthosis in the prevention and treatment of thumb web contracture. Methods From February 2013 to October 2014, 42 cases with thumb web contracture were selected and randomly divided into 4 groups according to different treatments: stent & orthosis treatment group, stent treatment group, orthosis treatment group and conventional treatment group. After 16 weeks of follow-up, the width and angle of thumb web were observed and recorded. The superiority of each scheme was analyzed statistically. Results The width of thumb web increased (24.1±5.8) mm, (9.6±4.6) mm, (15.8±1.9) mm, (4.0±5.4) mm in stent & orthosis treatment group, stent treatment group, orthosis treatment group and conventional treatment group respectively 16 weeks after operation, and the differences among 4 groups were statistically significant (P<0.05). The angle of thumb web increased (23.5±6.1)°, (9.6±4.6)°, (15.7±1.9)°, (3.9±5.4)°in stent&orthosis treatment group, stent treatment group, orthosis treatment group and conventional treatment group respectively 16 weeks after operation, and the differences among 4 groups were statistically significant (P<0.05). Expect for one case of pinhole infection which cured after dressing change, no adverse reaction was observed. Conclusion Miniature stent combining hand orthosis for the prevention and treatment of thumb web contracture can effectively increase the width and angle of thumb web with less adverse reactions. It is worthy of popularization and application.