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微型外固定架联合克氏针治疗掌指关节开放性粉碎性骨折的临床观察

[Clinical observation of minor external fixation combined with Kirschner wire for open comminuted fracture of metacarpophalangeal joint].

作者信息

Li Cheng, Wang Nan, Bi Da-Wei

机构信息

Department of Orthopaedics, Fuyang Chinese Medical Orthopaedics Hospital, Hangzhou 311400, Zhejiang, China;

Department of Orthopaedics, Fuyang Chinese Medical Orthopaedics Hospital, Hangzhou 311400, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2016 Dec 25;29(12):1110-1113. doi: 10.3969/j.issn.1003-0034.2016.12.009.

Abstract

OBJECTIVE

To explore the method and therapeutic effect of minor external fixation combined with Kirschner Treatment for open comminuted fracture of metacarpophalangeal joint.

METHODS

From January 2013 to December 2014, 13 patients with open comminuted fracture of metacarpophalangeal joint were treated by minor external fixation combined with Kirschner wire, 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 type II, 4 cases were type IIIA, and 1 case was type IIIB. The time from injury to operation ranged from 2 to 7 h with an average of 5 h. All fractures were involved with metacarpal phalangeal joint surface. Fracture healing time and postoperative complications were observed, TAM scoring system by Hand Surgery Association of Chinese Medical Association was used to evaluate functional recovery.

RESULTS

All patients were followed up from 3 to 12 months with an average of 7 months. All fractures were obtained bone healing, and the time ranged from 4 to 6 weeks with an average of (4.6±1.0) weeks. No broken and loose needle, pin track infections, malunion, loose bracket, reflection sexual sense of neurological malnutrition occurred. According to TAM scoring system, 7 cases obtained excellent results, 4 cases good, 1 case moderate and 1 case poor.

CONCLUSIONS

Minor external fixation combined with Kirschner wire for open comminuted fracture of metacarpophalangeal joint has advantages of simple operation, good stability and which could be adjusted at the later stage, less damage for soft tissue periosteum, low inflammatory, earlier functional exercise. It is worth to be popularized and applied.

摘要

目的

探讨微型外固定架结合克氏针治疗开放性掌指关节粉碎性骨折的方法及疗效。

方法

选取2013年1月至2014年12月采用微型外固定架结合克氏针治疗的13例开放性掌指关节粉碎性骨折患者,其中男9例,女4例;年龄18~56岁,平均35岁。按Gustilo分类,Ⅱ型8例,ⅢA型4例,ⅢB型1例。受伤至手术时间2~7 h,平均5 h。所有骨折均累及掌指关节面。观察骨折愈合时间及术后并发症,采用中华医学会手外科学会TAM评分系统评价功能恢复情况。

结果

所有患者均获随访,时间3~12个月,平均7个月。所有骨折均骨性愈合,愈合时间4~6周,平均(4.6±1.0)周。未出现克氏针折断、松动,针道感染,畸形愈合,外固定架松动,反射性交感神经营养不良等情况。按TAM评分系统评定,优7例,良4例,可1例,差1例。

结论

微型外固定架结合克氏针治疗开放性掌指关节粉碎性骨折具有操作简单、稳定性好、后期可调整、对软组织及骨膜损伤小、炎症反应轻、功能锻炼早等优点,值得推广应用。

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