闭合复位顺行双弹性钉固定治疗掌骨骨折疗效分析  

Analysis of the clinical efficacy of closed reduction and antegrade double elastic nail fixation of metacarpal fractures

作　　者：黄俊伍[1] 陈云丰[2] 罗轶[1] 张春林[2] 

机构地区：[1]上海市第六人民医院金山分院骨科,201599 [2]上海市第六人民医院骨科

出　　处：《中华手外科杂志》2013年第5期263-266,共4页Chinese Journal of Hand Surgery

摘　　要：目的分析闭合复位顺行双弹性钉固定治疗掌骨骨折的临床疗效。方法回顾分析经完整随访的26例35处掌骨骨折患者的治疗和康复情况，26例35处掌骨骨折患者均行闭合复位双弹性钉内固定术。按照TAFS系统评价法分别观察测量手指屈曲伸直功能恢复的情况，同时对患指术后的肌力和感觉进行评价。结果经过8～24个月（平均11个月）的随访，术后无明显骨折移位丢失，无伤口感染及骨不连等并发症；骨折平均愈合时间为（6．27±3．77）周；术后功能疗效评定参照TAFS的评分标准，掌指关节功能优良率为92．23％；肌力和感觉与健侧相比无明显差异。结论闭合复位顺行双弹性钉固定治疗掌骨骨折，手术损伤小，可以早期功能锻炼，减少肌腱粘连和关节僵硬，手指功能恢复好。Objective To analyze the clinical efficacy of closed reduction and antegrade double elastic nail fLxation of metacarpal fractures. Methods A retrospective review of 35 metacarpal fractures in 26 patients who had complete follow-up was conducted. All these metacarpal fractures were closed ones and were treated with closed reduction and double elastic nail fixation. TAFS system was adopted to measure and evaluate finger flexion and extension functional recovery. Muscle power and sensation of the involved fingers were also evaluated. Results No fracture displacement or loss of reduction was noted after 8 to 24 months （mean, 11 months） of postoperative follow-up. There were no complications such as wound infection or nonunion. The average fracture healing time was （6.27±3.77） weeks. Based on the TAFS functional efficacy scoring system the metacarpophalangeal joint function was rated as excellent in 92.23 % of the cases. The strength and sensation of the affected fingers were not significantly different from those of the unaffected fingers. Conclusion Closed reduction and antegrade double elastic nail fixation of metacarpal fractures allows early functional exercises and reduces tendon adhesion and joint stiffness. It is minimally invasive and leads to satisfactory recovery of finger movement.

关 键 词：掌骨 骨折 内固定术 

分 类 号：R687.3[医药卫生—骨科学]