第一掌骨基底骨折的分型收治  

Typing and Treatment of First Metacarpal Fracture

作　　者：方旭[1] 陆生林[1] 

机构地区：[1]广西民族医院骨科,南宁530001

出　　处：《医学综述》2013年第16期3041-3042,共2页Medical Recapitulate

摘　　要：目的探究第一掌骨基底骨折分型的收治方法。方法将广西民族医院2007年8月至2011年6月收治的124例第一掌骨基底骨折患者按照其骨折类型分为三组:克氏针联合微型钢板固定88例(A组),其中35例为Rolando骨折、29例为Bennett骨折、24例为基底关节内粉碎性骨折;切开复位螺钉内固定27例(B组),均为关节外骨折;微型指掌骨钢板9例(C组),均为骨骺分离型骨折。观察三组的最终疗效。结果 A组患者手指总主动活动度(TAM)评价优36例、良49例,优良率为96.6%;B组优9例、良16例,优良率为92.6%;C组优6例、良2例,优良率为100.0%,三组患者治疗效果均令人满意。结论对于Bennett骨折、Rolando骨折及关节内粉碎性骨折宜采取克氏针联合微型钢板内固定法,关节外骨折宜采取切开复位螺钉内固定法,而骨骺分离患者宜采用微型指掌骨钢板固定,具有良好的治疗效果,值得临床广泛推广。Objective To explore the classification method of the first metacarpal fractures.Methods From August 2007 to June 2011 124 cases of the first metacarpal base fracture in Guangxi National Hospital were divided into three groups according to the treatment methods：,Kirschner wire combined with mini-plate fixation in 88 cases（group A）,including 35 cases of Rolando fracture,29 cases of Bennett fracture,24 cases of basal joint fractures;open reduction and screw internal fixation in 27 cases（group B）,all with extra-articular fractures;micro metacarpal plate in 9 cases（group C）,all with epiphysiolysis fracture.The final effects of the three groups were observed.Results The TAM were excellent in 36 cases,good in 49 cases,forming an excellent and good rate of 96.6% in group A,were excellent in 9 cases,good in 16 cases,forming an excellent and good rate of 92.6% in group B;TAM were excellent in 6 cases,good in 2 cases forming an excellent and good rate of 100.0% in group C.The therapeutic effects of the three groups were satisfactory.Conclusion For Bennett fracture,Rolando fracture and comminuted intra-articular fracture the Kirschner combined with mini-plate internal fixation should be adopted,extra-articular fractures should be treated by open reduction and screw fixation,and the patients with separated epiphysis separation should be treated with miniaturized metacarpus steel plate,which all have good therapeutic effects and are worthy of clinical application.

关 键 词：掌骨 基底骨折 分型 治疗 疗效 

分 类 号：R683.41[医药卫生—骨科学]