| 指掌骨骨折内固定术后并发症原因分析及对策 |
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Received:June 21, 2010
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| 作者 | Author | 单位 | Unit | E-Mail |
| 闫玉明 |
YAN Yu-ming |
镇海第二医院手外科，浙江 宁波 315207 |
Department of Hand Surgery,the Second Hospital of Zhenhai,Ningbo 315207,Zhejiang,China |
yanyuming2003@163.com |
| 张伟平 |
ZHANG Wei-ping |
镇海第二医院手外科，浙江 宁波 315207 |
Department of Hand Surgery,the Second Hospital of Zhenhai,Ningbo 315207,Zhejiang,China |
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| 廖勇 |
LIAO Yong |
镇海第二医院手外科，浙江 宁波 315207 |
Department of Hand Surgery,the Second Hospital of Zhenhai,Ningbo 315207,Zhejiang,China |
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| 翁则福 |
WENG Ze-fu |
镇海第二医院手外科，浙江 宁波 315207 |
Department of Hand Surgery,the Second Hospital of Zhenhai,Ningbo 315207,Zhejiang,China |
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| 任唯杰 |
REN Wei-jie |
镇海第二医院手外科，浙江 宁波 315207 |
Department of Hand Surgery,the Second Hospital of Zhenhai,Ningbo 315207,Zhejiang,China |
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| 林君 |
LIN Jun |
镇海第二医院手外科，浙江 宁波 315207 |
Department of Hand Surgery,the Second Hospital of Zhenhai,Ningbo 315207,Zhejiang,China |
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| 唐贤翱 |
TANG Xian-ao |
镇海第二医院手外科，浙江 宁波 315207 |
Department of Hand Surgery,the Second Hospital of Zhenhai,Ningbo 315207,Zhejiang,China |
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| 期刊信息：《中国骨伤》2011年24卷，第3期，第199-201页 |
| DOI：10.3969/j.issn.1003-0034.2011.03.006 |
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目的：探讨指掌骨骨折内固定术后并发症的原因，提出预防对策。
方法：回顾性总结2007年7月至2009年10月内固定手术治疗的342例指掌骨骨折患者，男203例，女139例；年龄18～56岁，平均30.4岁；右手217例，左手125例。第1掌骨38个，第2掌骨47个，第3掌骨52个，第4掌骨40个，第5掌骨39个，近节指骨43个，中节指骨52个，远节指骨48个。克氏针内固定129例，微型钢板内固定153例，单纯微型螺钉固定48例，钢丝捆扎12例。
结果：324例获得随访，时间3～15个月，平均8.5个月。74例出现术后并发症，发生率22.84%.术后并发症包括伤口愈合欠佳24例，占7.4%;肌腱粘连54例，占16.67%;骨折畸形愈合34例，占10.49%;骨折不愈合13例，占4.01%;指骨短缩21例，占7.41%.
结论：内固定物选择不当、手术操作技术欠佳以及术后没有进行早期很好的康复功能锻炼是术后并发症的主要原因。 |
| [关键词]:指 掌骨 骨折 骨折固定术，内 手术后并发症 |
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| Analysis and prevention of the complications after treatment of metacarpal and phalangeal fractures with internal fixation |
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Abstract:
Objective: To retrospective analysis the complications after treatment of metacarpal and phalangeal fractures with internal fixation,and propose measures to prevent or reduce surgical complications.
Methods: From July 2007 to October 2009,342 patients with metacarpal and phalangeal fractures were treated with internal fixation,including 203 males and 139 females with an average age of 30.4 years old ranging from 18 to 56 years. There were 217 right hands and 125 left hands,38 cases of the first metacarpal fracture,47 cases of the second metacarpal fracture,52 cases of the third metacarpal fracture,40 cases of the forth metacarpal fracture,39 cases of the fifth metacarpal fracture,43 cases of the proximal phalangeal fractures,52 cases of the middle phalangeal fractures,and 48 case of the distal phalangeal fractures. The fractures were fixed with K-wires in 129 patients,mini plates in 153 cases,screws in 48 cases,wires in 12 cases.
Results: All 324 patients were followed up for 3 to 15 months(averaged 8.5 months) and complications occurrenced in 74 patients (22.84%). The main complication was unhealthy wound healing in 24 patients(7.4%),others was adhesion of tendon in 54 patients(16.67%),malunion in 34 patients(10.49%),nonunion in 13 patients(4.01%) and shortening of metacarpal and phalangeal in 21 patients(7.41%).
Conclusion: The important reasons responsible for complications are iatrogenic factors such as unsuitable implant selection,unskillful surgical technique and improper post-operative functional rehabilitation. |
| KEYWORDS:Finger Metacarpus Fractures Fracture fixation,internal Postoperative complications |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 闫玉明,张伟平,廖勇,翁则福,任唯杰,林君,唐贤翱.指掌骨骨折内固定术后并发症原因分析及对策[J].中国骨伤,2011,24(3):199~201 |
| 英文格式: | YAN Yu-ming,ZHANG Wei-ping,LIAO Yong,WENG Ze-fu,REN Wei-jie,LIN Jun,TANG Xian-ao.Analysis and prevention of the complications after treatment of metacarpal and phalangeal fractures with internal fixation[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(3):199~201 |
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