【摘要】 目的 探究微型空心螺钉治疗末节指骨远端骨折(DPF)患者的效果。方法 选取濮阳市中医医院2019年5月—2022年9月94例DPF患者，按随机数字表法分成A组(n=47)、B组(n=47)。B组接受克氏针内固定(KWIF)治疗，A组接受微型空心螺钉内固定治疗。对比2组骨折愈合率、患指功能优良率、手术前后血清护骨素-核因子κB受体活化因子-核因子κB受体活化因子配体(OPG/RANK/RANKL)水平、应激指标[P物质(SP)、白细胞介素-6(IL-6)、降钙素原(PCT)、前列腺素E2(PGE2)]水平、并发症发生率。结果 与B组骨折愈合率80.85%(38/47)相比，A组95.74%(45/47)更高(P<0.05);与B组相比，A组术中透视次数更少，手术耗时更短(P<0.05);与B组患指功能优良率70.21%(33/47)相比，A组91.49%(43/47)更高(P<0.05);与B组对比，术后1个月、3个月A组血清OPG水平更高，血清RANK、RANKL水平更低(P<0.05);与B组相比，术后1 d、3 d A组血清SP、IL-6、PCT、PGE2水平更低(P<0.05);与B组并发症总发生率17.02%(8/47)相比，A组2.13%(1/47)更低(P<0.05)。结论 与KWIF治疗DPF患者相比，应用微型空心螺钉治疗可有效优化手术指标，提高患指功能，调节OPG/RANK/RANKL系统，促进骨折愈合，减少并发症，且对机体产生应激反应更小。更多还原

【Abstract】 Objective To investigate the effectiveness of miniature hollow screws in the treatment of patients with distal phalangeal fractures(DPF). Methods Ninety-four patients with DPF in our hospital from May 2019 to September 2022 were selected and divided into group A(n=47) and Group B(n=47) according to random number table method. Group B was treated with KWIF, and group A was treated with miniature hollow screw. The rate of fracture healing, the excellent rate of function of the affected finger, serum osteoprotegerin-nuclear factor κB receptor activating factor-nuclear factor κB receptor activating factor ligand(OPG/RANK/RANKL) level, stress index [Substance P(SP), interleukin-6(IL-6), procalcitonin(PCT), prostaglandin E2(PGE2)] level, complication rate before and after operation were compared between the two groups. Result The fracture healing rate was higher in group A [(95.74%(45/47)] compared with group B [80.85%(38/47)](P<0.05); the number of intraoperative fluoroscopies was less and the operative time was shorter in group A compared with group B(P<0.05); the functional excellence rate of the affected finger was higher in group A [91.49%(43/47)] compared with group B [70.21%(33/47)](P<0.05). Compared with group B, serum OPG levels were higher and serum RANK and RANKL levels were lower in group A at 1 month and 3 months postoperatively(P<0.05); serum SP, IL-6, PCT, and PGE2 levels were lower in group A at 1 d and 3 d postoperatively compared with group B(P<0.05); and the overall complication rate [2.13%(1/47)] was lower in group A compared with group B [17.02%(8/47)](P<0.05). Conclusion Compared with KWIF for patients with DPF, the application of miniature hollow screw treatment can effectively optimize the surgical index, improve the function of the affected finger, regulate the OPG/RANK/RANKL system, promote fracture healing, reduce complications, and produce less stress on the organism.更多还原