微型钢板内固定治疗单手多发掌骨骨折  

Internal fixation with mini-plates for treatment of ipsilateral multiple metacarpal fracture

作　　者：从飞[1] 宋涛[1] 欧学海[1] 杜小龙[1] 范金柱[1] Cong fei Song Tao Ou Xuehai et al(Department of Orthopaedics, Microsurgical Repair of Bone, Xi＇an Honghui Hospital, Xi＇an Jiaotong University Health Science Center, Xi＇an 710054, China)

机构地区：[1]西安交通大学医学部附属红会医院骨显微修复外科,710054

出　　处：《美中国际创伤杂志》2016年第3期14-17,共4页U.S.Chinese International Journal of Traumatology

摘　　要：目的：探讨应用微型钢板内固定治疗单手多发掌骨骨折的效果。方法：回顾性分析2008年9月至2013年6月，采用微型钢板内固定治疗16例单手多发（至少3个掌骨）掌骨骨折的患者资料，骨折合并急性骨筋膜间室综合征4例；合并急性腕管综合征2例；3处掌骨骨折10例，4处掌骨骨折6例，共54处掌骨骨折；均早期行切开减压复位内固定术，未做腕管切开减压，术后伤口一期关闭，辅以早期功能锻炼及正确的康复指导。结果：术后16例伤口全部一期愈合，未出现内在肌坏死及正中神经损伤并发症。术后随访5～18个月，15例患者骨折一期愈合，1例患者的第三掌骨骨折出现骨不连及钢板断裂，经植骨内固定术后5个月愈合。按手指总主动活动度（TAM）功能评定，优良率达到90．7％（49，54）。结论：应用微型钢板内固定治疗多发掌骨骨折，早期手术，可在切开固定骨折端的同时对筋膜问室减压，有利于防治急性骨筋膜间室综合征和术后早期功能锻炼，疗效满意。Objective： To investigate the outcome of internal fixation with mini-plates for treatment of ipsilateral multiple metacarpal fracture. Methods： From September 2008 to June 2013, 16 patients with ipsilateral multiple metacarpal fractures （at least 3 metacarpals） were treated with open decompression, reduction and mini-plates internal fixation in the early stage. Of the total, combine with acute osteofascial compart- ment syndrome and acute carpal tunnel syndrome in 4 and 2 cases, respectively. Then give early functional exercise and correct rehabilitation instruction. Results： After operation, the wound obtained primary healing in all eases, no complications such as intrinsic myonecrosis or median nerve injury happed. After 5-18 months follow-up, bony union noted in 15 cases, nonunion appeared at the thirdmetacarpal bone in 1 case, bone graft and internal fixation was performed on the patient and healed 5 months later. According to the function evaluation of TAM scales, the excellent and good rat was 90.7%（4-9/54）. Conclusion： For patients with ipsilateral multiple metacarpal fractures, early open reduction and internal fixation with mini-plates, and fascia compartment decompression simultaneously can prevent osteofascial compartment syndrome and is ben- efit for patients to carry out early functional exercise postoperatively.

关 键 词：掌骨 微型钢板 骨折固定术 

分 类 号：R782.4[医药卫生—口腔医学]