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手部指间或掌指关节周围小撕脱骨折微型钩钢板固定的临床疗效。

Clinical outcomes after mini-hook plate fixation for small avulsion fractures around the interphalangeal or metacarpophalangeal joints of the hand.

机构信息

Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, South Korea.

Department of Orthopedic Surgery, Hanyang University Guri Hospital, Guri, South Korea.

出版信息

J Orthop Surg Res. 2021 Mar 12;16(1):186. doi: 10.1186/s13018-021-02339-z.

Abstract

BACKGROUND

Mini-hook plate has been described for the treatment of various small avulsion fragments in the hand. This retrospective study aimed to evaluate clinical outcomes after mini-hook plate fixation in patients with an avulsion fracture around the interphalangeal or metacarpophalangeal joints of the hand.

METHODS

Nineteen patients with avulsion fractures around the interphalangeal or metacarpophalangeal joints of the hand were included in this study. Seven patients had a mallet fracture, and 12 patients had other phalangeal avulsion fractures including central slip, collateral ligament, volar plate, and flexor avulsion fractures. The osseous union and functional outcomes, including finger joint motion, joint stability, pinching strength, and the disabilities of the arm, shoulder, and hand score, were evaluated.

RESULTS

The mean duration of follow-up was 33.8 months. All patients in mallet and other phalangeal avulsion fractures achieved osseous union between the avulsion fragment and phalangeal bone, and there was no joint subluxation. There were no significant differences in the disabilities of the arm, shoulder, and hand scores. However, the patients with mallet fracture have lower mean percentage values of the total active range of motion and pinching strength than other phalangeal avulsion fractures. We abandoned this procedure in mallet fractures because the early results after mini-hook plate fixation in mallet fractures appeared unfavorable.

CONCLUSION

These results suggest that the mini-hook plate fixation can provide sufficient stability and good clinical outcomes in those with phalangeal avulsion fractures. However, the outcomes for mallet fractures were not as good as those for other phalangeal avulsion fractures.

摘要

背景

迷你钩钢板已被用于治疗手部各种小撕脱碎片。本回顾性研究旨在评估手部近节指间关节或掌指关节周围撕脱骨折患者采用迷你钩钢板固定的临床结果。

方法

本研究纳入 19 例手部近节指间关节或掌指关节周围撕脱骨折患者。7 例为锤状指骨折,12 例为其他指骨撕脱骨折,包括中央束、侧副韧带、掌板和屈肌腱撕脱骨折。评估骨愈合和功能结果,包括指间关节活动度、关节稳定性、捏力和上肢、肩和手功能障碍评分。

结果

平均随访时间为 33.8 个月。所有锤状指和其他指骨撕脱骨折患者均实现了撕脱骨块与指骨之间的骨愈合,无关节半脱位。上肢、肩和手功能障碍评分无显著差异。然而,锤状指骨折患者的总主动活动度和捏力的平均百分比值均低于其他指骨撕脱骨折。我们放弃了锤状指骨折的这种手术方法,因为迷你钩钢板固定后早期结果不理想。

结论

这些结果表明,迷你钩钢板固定可提供足够的稳定性和良好的临床结果,适用于治疗指骨撕脱骨折。然而,对于锤状指骨折的效果不如其他指骨撕脱骨折。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24f7/7953753/37d26d8879f7/13018_2021_2339_Fig1_HTML.jpg

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