切开复位内固定联合韧带重建治疗陈旧性Bennett骨折  

Open reduction and internal fixation combined with ligament reconstruction in the treatment of old Bennett fracture

作　　者：冯小兵 吴天昊[1] 颜泉[1] 杨琨 谢桃红 Feng Xiaobing;Wu Tianhao;Yan Quan;Yang Kun;Xie Taohong(Department of Orthopedics,Luzhou People′s Hospital,Sichuan 646000,China)

机构地区：[1]四川省泸州市人民医院骨科,四川646000

出　　处：《中华手外科杂志》2020年第4期267-270,共4页Chinese Journal of Hand Surgery

摘　　要：目的探讨切开复位内固定联合韧带重建治疗陈旧性Bennett骨折的疗效。方法自2014年9月至2018年3月,我们共收治51例陈旧性Bennett骨折患者,随机分为治疗组28例和对照组23例。治疗组采用骨折切开复位内固定并联合桡侧腕屈肌腱部分转位重建掌侧韧带治疗;对照组采用单纯切开复位内固定,未行韧带重建。术后随访按照总主动活动度(total active motion,TAM)系统评价法进行拇指功能评价。结果术后51例患者均获得随访,时间为8~16个月,平均14.5个月。所有患者骨折均骨性愈合,对照组1例患者出现再脱位,其余均无再脱位发生。根据TAM系统评价法评价拇指功能:治疗组优14例、良11例、可2例、差1例,优良率为89.29%;对照组优6例、良9例、可5例、差3例,优良率为65.22%。治疗组疗效明显优于对照组,差异有统计学意义(Z=-2.184,P=0.031)。结论切开复位内固定联合桡侧腕屈肌腱部分转位重建掌侧韧带治疗陈旧性Bennett骨折,复位及固定牢靠,疗效确切,能显著改善患侧拇指功能。Objective To investigate the clinical efficacy of open reduction and internal fixation combined with ligament reconstruction in the treatment of old Bennett fracture.Methods From September 2014 to March 2018,51 patients with old Bennett fracture were randomly divided into treatment group(28 cases)and control group(23 cases).The treatment group was treated with open reduction and internal fixation of fracture and partial transposition of flexor carpi radialis tendon to reconstruct the palmar ligament;the control group was treated with open reduction and internal fixation without ligament reconstruction.The function of thumb was evaluated by total active motion(TAM)system.Results All the 51 patients were follow-up for 8 to 16 months with an average of 14.5 months.All the fractures achieved bony healing.In the control group,1 case had re-dislocation,and the rest had no re-dislocation.According to the TAM system evaluation,the thumb function of the treatment group was evaluated as excellent in 14 cases,good in 11 cases,fair in 2 cases and poor in 1 case with the excellent and good rate being 89.29%;the control group was evaluated as excellent in 6 cases,good in 9 cases,fair in 5 cases and poor in 3 cases with the excellent and good rate being 65.22%.The clinical efficacy of the treatment group was significantly better than that of the control group(Z=-2.184,P=0.031).Conclusion The open reduction and internal fixation combined with partial transposition of flexor carpi radialis tendon to reconstruct the palmar ligament are effective in the treatment of old Bennett fracture.

关 键 词：骨折固定术 内 治疗结果 BENNETT骨折 韧带重建 

分 类 号：R687.3[医药卫生—骨科学]