摘要
目的探讨AO微型钢板螺钉治疗掌指骨骨折术后骨不连或畸形愈合的应用价值。方法对11例14个掌指骨骨折克氏针固定术后骨不连或畸形愈合者采用手术治疗,其中指骨骨不连7个,掌骨骨不连5个,掌骨畸形愈合2个。术中骨折端修整,取自体髂骨植骨12个,畸形愈合行截骨矫正2个。11例均应用AO微型钢板螺钉内固定,同期行肌腱或关节囊松解术,术后早期行关节功能锻炼。结果术后随访4～12个月,11例均于术后6～8周达到骨折临床愈合,无畸形愈合。根据TAFS评分,2例为优,9例为良,3例差,优良率为78.5 %。结论AO微型钢板螺钉内固定,自体骨植骨,同期行肌腱和关节囊松解以及术后早期关节功能锻炼,是掌指骨骨不连或畸形愈合的治疗原则。
Objective To evaluate the outcome of AO mini-plate and screw fixation for treatment of nonunion or malunion of metacarpal and phalangeal fractures. Methods 14 metacarpal and phalangeal fractures in 11 cases were involved in the study. Nonunion or malunion occurred in these fractures after Kirschner wire fixation. There were 7 phalangeal nonunions, 5 metacarpal nonunions, and 2 metacarpal malunions. The fractures were re-fixed using AO mini-plates and screws, with iliac bone graft for the nonunions and osteotomy for the malunions respectively. Tenolysis and joint capsule release were carried out simultaneously. Rehabilitation started early after the operation. Results The patients were followed for 4～12 months. By 6～8 weeks posoperatively bone union was achieved. There was no malunion. Application of TAF scale graded the results as excellent in 2 cases, good in 9 cases and poor in 3 cases. The excellent and good rate was 78.5%. Conclusion AO Mini-plate fixation along with bone grafting and releasing of tendons and joint capsules are the principles for treatment of nonunion or malunion of metacarpal and phalangeal fractures.
出处
《中华手外科杂志》
CSCD
北大核心
2005年第2期101-102,共2页
Chinese Journal of Hand Surgery
