Crawford G P
J Bone Joint Surg Am. 1976 Jun;58(4):487-92.
Twenty-one patients with fractures of the bones of the hand were treated by open reduction and internal fixation with compression screws. The firm fixation allowed range-of-motion exercises in most patients to be begun on the third postoperative day. On follow-up mild restriction in digital motion was seen in only one patient, and significant disturbance in joint function was not encountered. In spite of these advantages, the method is indicated in only a small percentage of such fractures. Usually traditional methods of open reduction and internal fixation are preferred when an open procedure is needed. However, oblique and spiral fractures of the proximal phalanx, some fractures with large single articular fragments particularly involving the proximal interphalangeal joint, and appropriate Bennett's fractures are suitable for screw fixation.
21例手部骨折患者接受了切开复位并用加压螺钉内固定治疗。牢固的固定使大多数患者在术后第三天即可开始进行活动度锻炼。随访时仅1例患者出现轻度手指活动受限，未发现关节功能严重障碍。尽管有这些优点，但该方法仅适用于一小部分此类骨折。通常，需要进行切开手术时，传统的切开复位内固定方法更受青睐。然而，近节指骨的斜形和螺旋形骨折、一些伴有大的单关节碎片（特别是累及近端指间关节）的骨折以及合适的 Bennett 骨折适合用螺钉固定。
