自制简易动态外固定架治疗PIP关节不稳定性骨折脱位  

Treatment of unstable fracture-dislocation of the proximal interphalangeal joint with the self-made dynamic simple external fixator

作　　者：纪翔 刘育杰[2] 丁小珩[2] 屈志刚[2] 姜凯[2] 张宏勋[2] 焦鸿生[2] 仲霄鹏[2] 刘春雷[2] 郑波[2] 

机构地区：[1]青岛市中心医院烧伤科,山东青岛266300 [2]中国人民解放军第401医院手外科,山东青岛266071

出　　处：《实用手外科杂志》2017年第1期56-58,61,共4页Journal of Practical Hand Surgery

摘　　要：目的 探讨自制简易动态外固定架治疗近侧指间关节不稳定性骨折脱位的疗效.方法 2010年8月-2013年10月,对8例近侧指间关节不稳定性骨折脱位（Hasting分型Ⅱ、Ⅲ型）采用自制简易动态外固定牵引架治疗.通过患指的正侧位X线片确诊.Ⅰ期行骨折闭合复位,采用自制的简易动态外固定架固定.结果 术后患者伤口愈合可,无钉道感染等并发症.8例获1~2年随访,X线示骨折全部愈合;关节脱位复位满意;所有PIP关节活动基本恢复正常,屈曲平均95°（90°~100°）,伸直平均2.5°（0°~10°）.按照中华医学会手外科学分会全指关节活动度（TAM）系统评定：优5例,良2例,可1例,优良率为83%;采用VAS评分评价患者的主观满意度,平均8.6（8~10）分.结论 自制简易动态外固定架治疗PIP关节不稳定性骨折脱位,方便、实用、价廉,对PIP关节不稳定性骨折脱位具有良好的疗效.Objective To explore the treatment of the unstable fracture-dislocation of the proximal interphalangeal joint by using self-made dynamic simple external fixator. Methods From August 2010 to October 2013, 8 patients with unstable fracture-dislocation of the proximal interphalangeal joint were treated with self-made dynamic distraction external fixator. The diagnosis were confirmed by x-ray . After closed reduction, fracture was fixed with self-made dynamic simple external fixaor. Results Primary healing of incision was obtained in 8 cases and no pin hole infection was found. The mean follow-up was 1 year （range, 1 year to 2 years）. X-ray showed bone union in all the cases, and satisfactory joint reduction was obtained. The flexion of the PIP joint were 90~100 （mean, 95） degrees and extension were 0~10 （mean, 2.5） degrees respectively. According to the measurement of Total Active Movement （TAM）for 8 patients who obtained fracture healing, the results were excellent in 5 cases, good in 2 cases, fair in 1 case, the excellent and good rate was 83%. The average of VAS score was 8.6 points. Conclusion The treatment of unstable fracture-dislocation of the PIP joint with the self-made dynamic simple external fixaor is a simple procedure, with excellent outcomes.

关 键 词：近侧指间关节 外固定架 脱位 骨折 

分 类 号：R684[医药卫生—骨科学]