张力带钢丝法治疗撕脱骨折型拇指掌指关节桡侧副韧带损伤  

Application of tension band wire in the treatment of avulsion fracture type radial collateral ligament injuries of thumb metacarpophalangeal joint

作　　者：杨焕友[1] 王斌[1] 李瑞国[1] 王伟[1] 王辉[1] 张剑铎 Yang Huanyou;Wang Bin;Li Ruiguo;Wang Wei;Wang Hui;Zhang Jianfeng(Department of Hand Surgery, the Second Hospital of Tangshan, Tangshan 063000, China)

机构地区：[1]唐山市第二医院手一科,河北063000

出　　处：《中华手外科杂志》2019年第1期40-42,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨急性撕脱骨折型拇指掌指关节桡侧副韧带损伤的治疗方法及疗效。方法自2014年7月至2017年12月,我们对9例急性撕脱骨折型拇指掌指关节桡侧副韧带损伤患者,采用张力带克氏针、钢丝法固定撕脱骨块,重建韧带止点,掌指关节屈曲15°位固定。3周后练习拇指关节活动。结果术后9例均获得随访,时间为6~28个月,平均15个月,掌指关节稳定,拇指指间关节活动及捏力良好。X线片示近节指骨桡侧副韧带止点撕脱骨折块均达到骨性愈合,骨折愈合时间为4~6周。采用中华医学会手外科学会上肢部分功能评定试用标准评定:优8例,良1例。结论张力带钢丝法固定撕脱骨折块,重建拇指掌指关节桡侧副韧带止点稳定性高,手术操作简单,疗效满意。ObjectiveTo explore the treatment method and clinical efficacy of acute avulsion fracture type radial collateral ligament injuries of thumb metacarpophalangeal joint.MethodsFrom July 2014 to December 2017,9 patients with acute avulsion fracture type radial collateral ligament injuries of thumb metacarpophalangeal joint were treated with tension band Kirschner wire and steel wire to fix avulsion bone fragments and reconstruct ligament insertion.The metacarpophalangeal joint was fixed at 15°of flexion.The thumb exercise was conducted 3 weeks postoperatively.ResultsAll the 9 patients were follow-up for 6 to 28 months with an average of 15 months.The thumb metacarpophalangeal joint was stable and the interphalangeal joint had good movement and pinch strength.X-ray showed that all the avulsion fragments of the radial collateral ligament of proximal phalanx achieved bone healing,and the healing time was 4 to 6 weeks.According to the upper extremity functional evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association,the results were rated as excellent in 8 cases and good in 1 case.ConclusionFixing avulsed fragments by tension band steel wire can reconstruct the radial collateral ligament insertion of thumb metacarpophalangeal joint with high stability.It is simple operation with satisfactory curative effect.

关 键 词：拇指 骨折 掌指关节 桡侧副韧带 

分 类 号：R658.2[医药卫生—外科学]