摘要
目的探讨闭合复位双克氏针阻挡加压法治疗新鲜骨性锤状指的临床疗效。方法对35例新鲜骨性锤状指患者应用闭合复位骨块,1枚克氏针呈斜35°~40°方向背侧钻入中节指骨头,另1枚克氏针纵行固定DIP背伸5°位,在离患指尖约1 cm处,将背侧的克氏针折弯成"鱼钩"状,将"鱼钩"与掌侧的克氏针固定,以维持弹性加压。手术后第3周解除克氏针之间的加压装置,8周拔除克氏针,加强功能锻炼。术后根据Crawford评价标准进行疗效评定。结果 35例患者均获得3个月~24个月的随访,平均6.5个月。骨折均愈合,锤指畸形均矫正,手指外观满意。根据Crawford功能评价:优21例,良10例,可4例,优良率88.6%。结论闭合复位双克氏针阻挡加压法治疗新鲜骨性锤状指,可以对骨折间起到持续加压作用,促进骨折愈合,操作相对简单,疗效确切,外形美观,功能恢复好,值得借鉴。
Objective To investigate the clinical effect of closed reduction and double Kirschner wire block compression method in the treatment of fresh bony hammer fingers. Methods In 35 patients with fresh bony hammer fingers,closed reduction of bone mass was applied. One Kirschner wire was drilled into the middle phalanx at an oblique angle of 35 °-40 °,and another Kirschner wire was used to fix the DIP longitudinally. The 5 ° dorsal position is about 1 cm away from the fingertip of the patient. Bend the Kirschner wire on the dorsal side into a "fishhook" shape,and fix the "fishhook" to the Kirschner pin on the palm side to maintain elastic pressure;The compression device between Kirschner wires was released at 3 weeks after surgery,and the Kirschner wires were removed at 8 weeks to enhance functional exercise. Postoperative evaluation was based on the Crawford evaluation criteria. Results All 35 patients were followed up for 3 to 24 months,with an average of6.5 months. All the fractures healed,the hammer deformities were corrected,and the appearance of the fingers was satisfactory.According to Crawford function evaluation,21 cases were excellent,10 were good,4 were fair,and the excellent and good rate was 88.6%. Conclusion Closed reduction and double Kirschner wire block compression method can treat fresh bone hammer fingers with continuous compression effect on fractures and promote fracture healing. The operation is relatively simple,the effect is exact,the appearance is beautiful,and the function is restored. It is a treatment Ideal method for fresh bony hammer fingers.
作者
陈闵昌
朱红夷
陈孝军
王旭春
沈利平
Chen Minchang;Zhu Hongyi;Chen Xiaojun(The Wuxing District People's Hospital of Huzhou City,Huzhou,Zhejiang 313008)
出处
《基层医学论坛》
2020年第13期1779-1780,共2页
The Medical Forum
基金
湖州市科技局课题(2019GYB23)。
关键词
新鲜骨性锤状指
骨折固定术
闭合性复位
双克氏针
阻挡加压法
Fresh bony mallet fingers
Fracture fixation
Closed fracture fixation
Double kirschner wire
Blocking pressure method
