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微型组合式外固定架治疗近节指骨骨折
Hits: 262   Download times: 61   Received:August 13, 2023    
作者Author单位UnitE-Mail
申丰 SHEN Feng 浙江中医药大学附属江南医院手足外科, 浙江 杭州 311021 Department of Hand and Foot Surgery, Jiangnan Hospital Affiliated to Zhejiang Chinese Medicine University, Hangzhou 311201, Zhejing, China  
袁康 YUAN Kang 萧山区中医骨伤科医院手足外科, 浙江 杭州 311261 Department of Hand and Foot Surgery, Xiaoshan Orthopaedics Hospital of Traditional Chinese Medicine, Hangzhou 311201, Zhejiang, China  
王楠 WANG Nan 浙江中医药大学附属江南医院手足外科, 浙江 杭州 311021 Department of Hand and Foot Surgery, Jiangnan Hospital Affiliated to Zhejiang Chinese Medicine University, Hangzhou 311201, Zhejing, China wangnan1105@126.com 
期刊信息:《中国骨伤》2024年37卷,第10期,第1021-1024页
DOI:10.12200/j.issn.1003-0034.20230243
基金项目:杭州市萧山区社会发展重大科技计划政策引导项目(编号:2022322)


目的: 探讨应用微型组合式外固定架联合小切口有限切开复位治疗近节指骨骨折的临床疗效。

方法: 自2020年1月至2022年12月,采用微型组合式外固定架配合骨折平面的小切口切开复位治疗29例近节指骨骨折患者,其中男23例,女6例;年龄19~62(36.2±21.0)岁; 5例为开放性指骨骨折,Ⅰ期手术治疗;24例为闭合性指骨骨折,择期手术治疗。术后6个月随访时根据美国手外科协会手指总主动屈曲量表(total active flexion scale,TAFS)评价疗效,观察骨折愈合情况,钉道情况,局部软组织愈合情况,并发症情况。

结果: 29例患者均获随访,时间6~10(8.3±2.1)个月,3例出现骨折延迟愈合,1例出现远端皮肤感觉麻木,营养神经治疗后症状缓解,无外固定架断钉,无感染,钉道及小切口愈合良好,随访末期均达骨性愈合,骨折愈合时间10~24(13.7±3.1)周。术后6个月根据TAFS评定:优19例(227.68±4.23)分,良7例(203.86±14.32)分,差3例(170.33±7.32)分。

结论: 微型组合式外固定架联合小切口有限切开,复位治疗近节指骨骨折,操作简便,有利于早期功能锻炼,伸肌腱激惹小,Ⅱ期拆除便捷,恢复期功能评分优良率高。
[关键词]:微型  外固定  指骨骨折  骨折
 
Treatment of proximal phalangeal fracture with miniature combined external fixator
Abstract:

Objective To investigate the clinical effect of limited open reduction treatment of proximal phalangeal fracture with miniature external fixator combined with small incision.

Methods Between January 2020 and December 2022,29 patients with proximal phalangeal fracture were treated with micro external fixator combined with small incision in fracture plane,including 23 males and 6 females,aged from 19 to 62 years old with an average of (36.2±21.0) years old. Five patients with open phalangeal fracture were treated with stageⅠsurgery,24 cases of closed phalangeal fracture were treated with elective surgery. At the 6 month follow-up,the curative effect was evaluated according to the total active flexion scale (TAFS) of the American Hand Surgery Association. The fracture healing,nail path,local soft tissue healing,and complications were observed..

Results All the 29 patients were followed up for 6 to 10 months with an average of(8.3±2.1) months,3 patients had delayed fracture healing,1 patient had distal skin numbness,symptoms were relieved after nutritional nerve treatment,no external fixator broken nails,no infection,the nail path and small incision healing was good,bone healing was achieved at the end of follow-up. Fracture healing time ranged from 10 to 24 with an average of (13.7±3.1) weeks. Six months after operation,according to the TAFS standard,19 cases (227.68±4.23) were excellent,7 cases (203.86±14.32) were good,and 3 cases (170.33±7.32) were poor.

Conclusion The micro-combined external fixator combined with limited incision with small incision can be used in the treatment of proximal phalangeal fracture. The operation is simple and beneficial to early functional exercise,small extensor tendon irritation,convenient second-stage removal,and high rate of excellent and good functional score in recovery period. KEY WORDS Miniature; External fixation; Phalangeal fracture; Fracture
KEYWORDS:Miniature  External fixation  Phalangeal fracture  Fracture
 
引用本文,请按以下格式著录参考文献:
中文格式:申丰,袁康,王楠.微型组合式外固定架治疗近节指骨骨折[J].中国骨伤,2024,37(10):1021~1024
英文格式:SHEN Feng,YUAN Kang,WANG Nan.Treatment of proximal phalangeal fracture with miniature combined external fixator[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(10):1021~1024
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