掌骨和指骨手部骨折十年稳定内固定——危险因素及结果分析表明，与闭合性骨折相比，开放性骨折治疗中的并发症并未增加。
Ten years stable internal fixation of metacarpal and phalangeal hand fractures-risk factor and outcome analysis show no increase of complications in the treatment of open compared with closed fractures.
作者信息
Bannasch Holger, Heermann Anne K, Iblher Niklas, Momeni Arash, Schulte-Mönting Jürgen, Stark G Bjoern
机构信息
Departments of Plastic and Hand Surgery, University of Freiburg Medical Center, Freiburg, Germany.
出版信息
J Trauma. 2010 Mar;68(3):624-8. doi: 10.1097/TA.0b013e3181bb8ea0.
BACKGROUND
: Stable internal screw/plating systems for hand fractures have evolved during the last 20 years. The improved versatility leads to the increased use of these materials in open fractures, with the benefit of early mobilization. The aim of this retrospective study is to discern whether the broadening of the indications for these implants is accompanied by increased complication rates.
METHODS
: Data from 365 patients treated during the last 10 years at our department for metacarpal or phalangeal fractures with stable internal fixation by screw or plate were gathered and analyzed.
RESULTS
: Uneventful bony consolidation was observed in 91.2% (n = 333). The functional results were excellent to acceptable in 85.2%, whereas in 14.8% (n = 54), the result was unsatisfactory, the latter group presenting with concominant soft tissue injury. There was no statistically significant difference in infection and nonunion rates when comparing open and closed fractures.
CONCLUSION
: These results confirm that most patients with open metacarpal and phalangeal fractures can be treated by stable internal fixation.
背景
用于手部骨折的稳定内固定螺钉/钢板系统在过去20年中不断发展。其多功能性的提高导致这些材料在开放性骨折中的使用增加，有利于早期活动。这项回顾性研究的目的是确定这些植入物适应证的扩大是否伴随着并发症发生率的增加。
方法
收集并分析了过去10年在我们科室接受螺钉或钢板稳定内固定治疗的365例掌骨或指骨骨折患者的数据。
结果
91.2%（n = 333）观察到骨折顺利愈合。85.2%的功能结果为优至可接受，而14.8%（n = 54）的结果不满意，后一组伴有软组织损伤。比较开放性骨折和闭合性骨折时，感染率和骨不连率无统计学显著差异。
结论
这些结果证实，大多数开放性掌骨和指骨骨折患者可通过稳定内固定进行治疗。
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