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微型锁定钢板外固定治疗近节指骨粉碎性骨折

[Micro-locking plate external fixation for the treatment of proximal phalanx comminuted fractures].

作者信息

Wang Li-Xiang, Wang Nan, Xu Liang, Wu Guo-Ming

机构信息

Department of Hand and Foot Surgery, Jiangnan Hospital Affiliated to Zhejiang Chinese Medicine University, Hangzhou 311201, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2022 Dec 25;35(12):1189-92. doi: 10.12200/j.issn.1003-0034.2022.12.015.

Abstract

OBJECTIVE

To explore clinical efficacy of external placement of micro-locking plate combined with small incision reduction in treating proximal phalanx comminuted fractures.

METHODS

From January 2018 to December 2019, 17 patients with proximal phalanx comminuted fractures were treated with micro-locking plate combined with small incision open reduction, including 13 males and 4 females, aged from 16 to 64 years old with an average of (37.2±20.1) years old. Two patients were accompanied by soft tissue extrusion and opening injuries, which were treated with fixed treatment after the first-stage emergency debridement. Curative effect was evaluated according to total active flexion scale (TAFS) of American Hand Surgery Association at 6 months after operation;and fracture healing, nailing, local soft tissue healing, complications were observed.

RESULTS

All patients were followed up from 6 to 12 months with an avaerge of(9.3±3.6) months. Two patients occurred delayed union, 1 occurred local skin necrosis and was treated with the second-stage skin grafting to repair wound surface. No external screw breakage or infection was reported, skin soft tissue healed favorably and reached bony union, the union time from 12 to 24 weeks with an average of (15.7±2.1) weeks. According to TAFS standard, 9 patients got excellent result, 5 good and 3 poor at 6 months after operation.

CONCLUSION

External micro-locking plate combined with small incision reduction in treating proximal phalanx comminuted fracture, which has advantages of good condition of skin and soft tissue, simple operation, early functional exercise, good range of motion of interphalanx joint, and function score of recovery period is high.

摘要

目的

探讨微型锁定钢板外固定联合小切口复位治疗近节指骨粉碎性骨折的临床疗效。

方法

选取2018年1月至2019年12月采用微型锁定钢板联合小切口切开复位治疗的17例近节指骨粉碎性骨折患者,其中男13例,女4例;年龄16~64岁,平均(37.2±20.1)岁。2例伴有软组织挤压伤和开放性损伤,先行一期急诊清创后行固定治疗。术后6个月根据美国手外科协会总主动屈曲量表(TAFS)评价疗效;观察骨折愈合、内固定、局部软组织愈合及并发症情况。

结果

所有患者均获随访,随访时间6~12个月,平均(9.3±3.6)个月。2例发生延迟愈合,1例出现局部皮肤坏死,二期行植皮修复创面。未出现外固定螺钉断裂及感染情况,皮肤软组织愈合良好,达到骨性愈合,愈合时间12~24周,平均(15.7±2.1)周。术后6个月根据TAFS标准评定:优9例,良5例,差3例。

结论

微型锁定钢板外固定联合小切口复位治疗近节指骨粉碎性骨折,具有皮肤软组织条件好、手术操作简单、能早期进行功能锻炼、指间关节活动度良好、康复期功能评分高等优点。

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