摘要
目的探讨应用微型外固定支架结合有限内固定治疗掌指骨开放性粉碎性骨折的方法和疗效。方法2008年3月至2011年8月，应用微型外固定支架结合有限内固定治疗掌指骨开放性粉碎性骨折40例，其中男27例，女13例；年龄19—62岁，平均31．2岁。骨折部位：掌骨17例，指骨19例，掌、指骨同时骨折4例。所有病例采用单边微型外固定支架结合克氏针及可吸收线有限内固定，其中2例采用皮瓣覆盖创面，2例植皮，6例肌腱断裂予直接缝合。结果术后平均9周骨折愈合。2例发生外固定支架固定针松动，无固定针断裂。3例发生针道轻度感染未影响最终治疗。1例指骨有47的旋转，无成角畸形。按中华医学会手外科学会上肢部分功能评定试用标准评定息指运动功能：优12例，良21例，可5例，差2例；优良率82．5％。结论应用微型外固定支架结合有限内固定治疗掌指骨开放性粉碎性骨折方法可靠，能有效固定骨折，进行早期功能锻炼，恢复手指的活动功能。
Objective To explore the method and clinical outcome of limited open reduction and internal fixation combined with mini-external fixator for treatment of open commlnuted metacarpal and phalangeal fractttres. Methods From March 2008 to August 2011, 40 patients （27 males and 13 females） with open comminuted metacarpal and phalangeal fractures were treated. The patients＇ age ranged from 19 to 62 years, with an average of 31.2 years.There were 17 cases of metacarpal fractures, 19 cases of phalangeal fractures, and 4 cases of both metacarpal and phalangeal fractures. Mini unilateral external fixator was used in all the cases along with limited internal fixation by Kirschner wire and absorbable suture. Flap transfer was carried out in 2 cases and skin graft in 2 cases with severe soft tissue injury. Direct tenorrhaphy was done in 6 cases with tendon ruptures. Results All the fractures healed 9 weeks postoperatively. Pin loosening occurred in 2 cases while mild pin track infection occurred in 3 cases, all of which did not affect the outcome. 4° of phalange rotation was noted in 1 case. The upper limb functional evaluation criteria issued by the Chinese Hand Surgery Society was used to assess the motion function of the injured fingers and rate the overall results, which were excellent in 12 cases, good in 21 cases, fair in 5 cases and poor in 2 cases. The overall good-excellent rate was 82.5%. Conclusion Limited open reduction and internal faxation combined with mini-external ftxator is a reliable and effective method to treat open commlnuted metacarpal and phalangeal fractures. It allows early postoperative functional rehabilitation and restores the hand function.
出处
《中华手外科杂志》
CSCD
北大核心
2013年第1期4-6,共3页
Chinese Journal of Hand Surgery
关键词
骨折
开放性
骨折
粉碎性
掌骨
指骨
外固定支架
有限内固定
Fractures, open
Fractures, comminuted
Metacarpal bones
Finger phalanges
External fixator
Limited internal fixation
