摘要
目的 ：探讨应用微型外固定支架固定开放性粉碎性指骨骨折的临床疗效。方法 ：2013年1月至2014年12月,采用微型外固定支架不经关节固定治疗13例开放性粉碎性指骨骨折,其中男9例,女4例;年龄18~56岁,平均35岁。开放性骨折Gustilo分型：Ⅱ型8例,Ⅲ型5例。受伤至手术时间2~7 h,平均5 h。7例为指骨干骨折,6例骨折累及指骨关节面;其中1例合并指固有神经损伤;1例伴有软组织缺损,Ⅱ期皮瓣修复创面。术后石膏功能位固定2周,6~8周拆除外固定支架,积极行手指功能锻炼。结果 ：13例患者获得随访,时间3~12个月,平均7个月。1例出现掌指关节僵硬。术后无断钉、感染等发生,皮肤软组织愈合良好,均达骨性愈合,平均骨折愈合时间（4.6±1.0）周。术后功能恢复根据中华医学会手外科学会上肢断肢再植功能评定试用标准（TAM系统）评定,优7例,良4例,可1例,差1例。结论：微型外固定支架不经关节固定治疗开放性粉碎性指骨骨折,操作简便,稳定性好,可后期调整,对软组织骨膜破坏小,感染率低,可早期行功能锻炼,值得临床推广应用。
Objective：To explore therapeutic effects of minor external fixator for open comminuted phalangeal fractures with non transarticular. Methods：From January 2013 to December 2014,13 patients with open comminuted phalangeal fractures were treated by minor external fixator with non transarticular,including 9 males and 4 females aged from 18 to 56 years old with an average of 35 years old. According to Gustilo classification,8 cases were typeⅡ,and 5 cases were type Ⅲ. The time from injury to operation ranged from 2 to 7 h averaged 5 h. Seven patients were diagnosed as phalangeal fracture,6 patients were involved with joint surface of phalangeal,which 1 case combined with inherent nerve damage and 1 case combined with soft tissue defect repaired at stage Ⅱ. The patients were fixed by plaster for 2 weeks and removal external fixtor from 6 to 8weeks after operation and received functional exercise. Results：All patients were followed up from 3 to 12 months with an average of 7 months. One case occurred metacarpophalangeal joints stiffness. No screw breakage,inflammation occurred. Skin soft tissue recovered well and obtained bone healing,the average time of bone healing was（4.6±1.0） weeks. According to TAM scoring system used by Hand Surery Association of Chinese Medical Association,7 cases got excellent results,4 good,1 moderate and 1 poor. Conclusion：Minor external fixator for open comminuted phalangeal fractures with non transarticular has advantages of simple operation,good stability,and could adjust at the later stage,less damage for soft tissue periosteum,low inflammatory rate,earlier functional exercise. It is worth to be popularized and applied.
出处
《中国骨伤》
CAS
2015年第12期1121-1124,共4页
China Journal of Orthopaedics and Traumatology
关键词
骨折固定术
外
指骨
骨折
粉碎性
Fracture fixation
external
Phalangeal
Fractures
comminuted
