中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2010年
7期
662-665
,共4页
唐烽明%赵栋%谢鹏%王景贵%宁佳
唐烽明%趙棟%謝鵬%王景貴%寧佳
당봉명%조동%사붕%왕경귀%저가
掌骨%指骨%骨折%外固定器%内固定器
掌骨%指骨%骨摺%外固定器%內固定器
장골%지골%골절%외고정기%내고정기
Metacarpal bone%Finger phalanges%Fractures%External fixators%Internal fixators
目的 比较采用微型万向外固定器与微型钢板治疗掌指骨关节内骨折的疗效.方法 2002年10月至2008年3月,手术治疗掌指骨关节内骨折脱位患者106例,将患者随机分为外固定组和钢板组进行治疗.外固定组53例,采用微型万向外固定器或联用骨片钉、克氏针固定,男28例,女25例;年龄20.～62岁,平均33.5岁;拇指损伤24例,其余四指损伤29例;近端指间关节骨折脱位36例,掌指关节骨折脱位17例.钢板组53例,采用微型纯钛板螺钉进行固定,男30例,女23例;年龄23～66岁,平均36.5岁;拇指损伤22例,其余四指损伤31例;近端指间关节骨折脱位30例,掌指关节骨折脱位23例.采用Duncan等评分标准对两组患者手指关节活动度进行比较.结果 术后外固定组平均随访16.8个月,钢板组平均随访17.5个月.采用Duncan等评分标准评价手指功能的优良率:外固定组,优33例,良16例,可3例,差1例,优良率92.5%(49/53);钢板组,优30例,良17例,可5例,差1例,优良率88.7%(47/53).外固定组1例发生伤口感染,拇指关节平均活动度为134°±21°,其余四指为248°±19°;钢板组无伤口感染,拇指关节平均活动度为122°±18°,其余四指为225°±17°.结论 采用微型万向外固定器或联用经皮骨片钉、克氏针治疗掌指骨关节内骨折的术后疗效优于钢板螺钉固定的方法.
目的 比較採用微型萬嚮外固定器與微型鋼闆治療掌指骨關節內骨摺的療效.方法 2002年10月至2008年3月,手術治療掌指骨關節內骨摺脫位患者106例,將患者隨機分為外固定組和鋼闆組進行治療.外固定組53例,採用微型萬嚮外固定器或聯用骨片釘、剋氏針固定,男28例,女25例;年齡20.～62歲,平均33.5歲;拇指損傷24例,其餘四指損傷29例;近耑指間關節骨摺脫位36例,掌指關節骨摺脫位17例.鋼闆組53例,採用微型純鈦闆螺釘進行固定,男30例,女23例;年齡23～66歲,平均36.5歲;拇指損傷22例,其餘四指損傷31例;近耑指間關節骨摺脫位30例,掌指關節骨摺脫位23例.採用Duncan等評分標準對兩組患者手指關節活動度進行比較.結果 術後外固定組平均隨訪16.8箇月,鋼闆組平均隨訪17.5箇月.採用Duncan等評分標準評價手指功能的優良率:外固定組,優33例,良16例,可3例,差1例,優良率92.5%(49/53);鋼闆組,優30例,良17例,可5例,差1例,優良率88.7%(47/53).外固定組1例髮生傷口感染,拇指關節平均活動度為134°±21°,其餘四指為248°±19°;鋼闆組無傷口感染,拇指關節平均活動度為122°±18°,其餘四指為225°±17°.結論 採用微型萬嚮外固定器或聯用經皮骨片釘、剋氏針治療掌指骨關節內骨摺的術後療效優于鋼闆螺釘固定的方法.
목적 비교채용미형만향외고정기여미형강판치료장지골관절내골절적료효.방법 2002년10월지2008년3월,수술치료장지골관절내골절탈위환자106례,장환자수궤분위외고정조화강판조진행치료.외고정조53례,채용미형만향외고정기혹련용골편정、극씨침고정,남28례,녀25례;년령20.～62세,평균33.5세;무지손상24례,기여사지손상29례;근단지간관절골절탈위36례,장지관절골절탈위17례.강판조53례,채용미형순태판라정진행고정,남30례,녀23례;년령23～66세,평균36.5세;무지손상22례,기여사지손상31례;근단지간관절골절탈위30례,장지관절골절탈위23례.채용Duncan등평분표준대량조환자수지관절활동도진행비교.결과 술후외고정조평균수방16.8개월,강판조평균수방17.5개월.채용Duncan등평분표준평개수지공능적우량솔:외고정조,우33례,량16례,가3례,차1례,우량솔92.5%(49/53);강판조,우30례,량17례,가5례,차1례,우량솔88.7%(47/53).외고정조1례발생상구감염,무지관절평균활동도위134°±21°,기여사지위248°±19°;강판조무상구감염,무지관절평균활동도위122°±18°,기여사지위225°±17°.결론 채용미형만향외고정기혹련용경피골편정、극씨침치료장지골관절내골절적술후료효우우강판라정고정적방법.
Objective To compare the clinical outcome of external fixation device with Kirschner wire or fragment fixation pin with mini plate and screw fixation in treatment of metacarpal and phalangeal articular fracture dislocation. Methods From October 2002 to March 2008, 106 patients with metacarpal and phalangeal articular fracture dislocation were randomly divided into A and B group. The 53 patients in A group were treated with external fixation device with Kirschner wire or fragment fixation pin. There were thumb injury in 24 cases, fracture-dislocation of proximal interphalangeal joint(PIP) in 36 cases, fracture-dislocation of metacarpophalangeal joint (MP) in 17 cases. The 53 patients in B group were treated with mini plate and screw fixation. There were thumb injury in 22 cases, fracture-dislocation of PIP in 30 cases, fracture-dislocation of MP in 23 cases. Duncan rating criteria were used to compare finger range of motion. Results The mean follow-up of 16.8 and 17.5 months in A group and B group. According to Duncan rating criteria, there were excellent in 33 cases, good in 16, fair in 3, and poor in 1 case. The excellent and good rate was 92.5% in A group. There were excellent in 30 cases, good in 17, fair in 5, and poor in 1 case. The excellent and good rate was 88.7% in B group. In A group, 1 case of wound infection was found. The average arc of motion of thumb joint was 134°±21° while the average arc of motion of other fingers was 248°±19°. In B group, no wound infection occurred. The average arc of motion of thumb joint was 122°±18° while the average arc of motion of other fingers was 225°±17°. Conclusion External fixation device with Kirschner wire or fragment fixation pin was better than the application of mini plate and screw fixation in treatment of metacarpal and phalangeal articular fracture-dislocation.
