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[钉合固定治疗钩骨掌骨关节损伤]

[Staple fixation for the treatment of hamate metacarpal joint injury].

作者信息

Tang Yang-Hua, Zeng Lin-Ru, Huang Zhong-Ming, Yue Zhen-Shuang, Xin Da-Wei, Xu Can-Da

出版信息

Zhongguo Gu Shang. 2014 Mar;27(3):191-3.

Abstract

OBJECTIVE

To investigate the effcacy of the staple fixation for the treatment of hamate metacarpal joint injury.

METHODS

From May 2009 to November 2012,16 patients with hamate metacarpal joint injury were treated with staple fixation including 10 males and 6 females with an average age of 33.6 years old ranging from 21 to 57 years. Among them, 11 cases were on the fourth or fifth metacarpal base dislocation without fractures, 5 cases were the fourth or fifth metacarpal base dislocation with avulsion fractures of the back of hamatum. Regular X-ray review was used to observe the fracture healing, joint replacement and position of staple fixation. The function of carpometacarpal joint and metacarpophalangeal joint were evaluated according to ASIA (TAM) system evaluation method.

RESULTS

All incision were healed well with no infection. All patients were followed up from 16 to 24 months with an average of (10.0 +/- 2.7) months. No dislocation recurred, the position of internal fixator was good,no broken nail and screw withdrawal were occurred. Five patients with avulsion fracture of the back of hamatum achieved bone healing. The function of carpometacarpal joint and metacarpophalangeal was excellent in 10 cases,good in 5 cases, moderate in 1 case.

CONCLUSION

The application of the staple for the treatment of hamatometacarpal joint injury has the advantages of simple operation, small trauma, reliable fixation, early postoperative function exercise and other advantages, which is the ideal operation mode for hamatometacarpal joint injury.

摘要

目的

探讨吻合器固定治疗钩骨掌骨关节损伤的疗效。

方法

2009年5月至2012年11月,采用吻合器固定治疗16例钩骨掌骨关节损伤患者,其中男10例,女6例,平均年龄33.6岁,年龄范围21~57岁。其中,第4或第5掌骨基底脱位无骨折11例,第4或第5掌骨基底脱位合并钩骨背侧撕脱骨折5例。定期行X线复查,观察骨折愈合、关节复位及吻合器固定位置。采用亚洲脊髓损伤协会(TAM)系统评估方法评估腕掌关节和掌指关节功能。

结果

所有切口愈合良好,无感染。所有患者均获随访,时间16~24个月,平均(10.0±2.7)个月。无脱位复发,内固定位置良好,无断钉及螺钉松动。5例钩骨背侧撕脱骨折患者骨折愈合。腕掌关节和掌指关节功能优10例,良5例,可1例。

结论

吻合器应用于钩骨掌骨关节损伤的治疗,具有手术操作简单、创伤小、固定可靠、术后可早期进行功能锻炼等优点,是治疗钩骨掌骨关节损伤的理想手术方式。

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