Spin螺钉内固定术在治疗手部骨折中的应用  

Spin screw fixation in the treatment of hand fractures

作　　者：巨积辉[1] 李建宁[1] 李雷[1] 刘跃飞[1] 金光哲[1] 赵强[1] 魏诚[1] 刘新益[1] 侯瑞兴[1] 

机构地区：[1]苏州瑞华医院手外科,215124

出　　处：《中华关节外科杂志（电子版）》2010年第2期21-23,共3页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的探讨应用Spin螺钉治疗手部骨折的技术及临床疗效。方法自2004年10月至2008年10月,对采用Spin螺钉内固定手术治疗并获得随访的37例43处手部骨折的临床患者进行分析,其中闭合性骨折17例,开放性骨折20例,指骨骨折21例26处,掌骨骨折16例17处;关节内骨折22例,术后2周开始进行早期功能锻炼。结果术后伤口均一期愈合,经6～18个月(平均10个月)的随访,无伤口感染及骨髓炎发生。所有患者骨折均愈合,临床愈合时间为3～6周,骨性愈合时间为7～12周,内固定拆除时间为8～31周(平均12周),无创伤性关节炎发生,手指关节活动度按TAM/TAF法进行评价,属优者15例,良者18例,中者2例,差者2例,优良率89%。结论对于手部骨折,行切开复位,Spin螺钉内固定术,具有固定可靠、复位满意等优点,是一种有效的手术方法。选择合适的适应证,熟练的手术技巧及早期功能锻炼可以获得满意的疗效。Objective To investigate the application and the clinic curative effect of spin screw internal fixation for hand fractures. Methods 37 patients and 43 hand fractures were treated with spin screw internal fixation from October 2004 to October 2008. According to the clinical data, 17 cases were closed fracture; 20 cases were open fracture; 21 cases were phalangeal fracture in 26 fingers; 16 cases were metacarpus fracture at 17 points; 22 cases were intra-articular fracture. The patients started early functional exercise two weeks after surgery. Results The patients were followed up for 6-18 months （10 months in average）, healing by first intention in all cases, no wound infection and osteomyelitis. All cases reconstructed in 3-6 weeks clinically, bony union in 7-12 weeks. Internal fixation were backed out in 8-31 weeks （12 weeks in average）, no traumatic arthritis; the mobility of finger joint were assessed with TAM/ TAF method： 15 cases were excellent, 18 cases were good, 2 case were medium, and 2 cases were bad. The ratio of choiceness was 89%. Conclusions The method of spin screw internal fixation has been proved to be an effective treatment for hand fracture. Choosing appropriate indication, proficient surgery skills and early functional exercise are keys to achieve satisfying curative effect.

关 键 词：手损伤 骨折 内固定器 

分 类 号：R687.3[医药卫生—骨科学]