手指关节内骨折的治疗.pdfVIP

· 336· 中华手外科杂志2OO7年12月第23卷第6期 Chin JHand Surz。December2OO7。Vol 23，No．6 · 骨 关 节 疾 病 · 手指关节内骨折的治疗 赵少平 吴爱民 杨焕友 李瑞国 王立新 【摘要】 目的 探讨手指关节内骨折脱位的内固定方法及其疗效。方法 1994年6月一200r7 年1月，对25例28处手部关节内骨折的患者，分别采用张力带钢丝、微型螺钉和克氏针夹扣法固定 的方法进行治疗。并比较三种固定方法在近节指骨基底撕脱性骨折、近侧指间关节各型骨折的应 用选择及效果。结果 术后随访3个月～11．5年，平均6．4年。术后28处骨折均愈合。根据主观 和客观征象进行评定：优25处，良3处。x线片征象显示：优23处，良5处(为陈旧骨折)。手指关节 活动度为55o～110~，平均7 。结论 对手指关节内骨折，应重视骨折的精确复位和关节周围韧带 的保护、修复，指间关节侧方骨折脱位采用张力带钢丝固定或微型螺丝钉固定，指间关节背侧和掌 侧撕脱性骨折采用克氏针夹扣法固定可获得较满意的疗效。 【关键词】指骨；指关节；骨折；骨折固定术 暇I加 nt ofinlra-artiollar fractures of the血l窖ers Z 0 Shao-ping，IIIU Ai-rain， Huan-you，LI Rui-guo， 『G Li-xin．oepan,,~ ofHand Surgery，Tangshan Second Hospital，Hebei 063000，China 【Abstract】 Objee~ve To investigate the trealment options and outeonlte8 of intra-artlcular fractures of the fingel,s． Mellaods Twenty-eight intra-arficularfractures ofthe缶1只ers in 25 patients treatedfrom June 1994 tOJanuary 20Or7 were analysecl。Tension band fixation，mini．screw fixation and double Kirschner wire fixation were used．Applications and results ofthe 3fixationtechniquesin avulsionfractures ofthe proximal phalanx base and various types of fractures of the proximal interphalangeal joint were analysea and compared． Results Postoperativefollow-up ranged from 3 months tO l1．5 years(呦 6 years and 4 months)．Bone union was obtained in all the fractures．Twenty-five of the 28 fractures had lln excellent and 3 had a satisfactory result Oil clinical examination．The average range of motion for the involved joint was 7 (range，55。tO l10。)． Coneln~on Precise reduction and internal fixation of the fractured pieces and preservation of pariartieular ligaments were important in managing intra-ardcularfractures ofthe phalanx．Satisfactory treatment ollteom~c／in be obtained by using tension band fixation or mini一8CI~W fixation in lateral fraetuIe-dislocation of the interphal