应用微型钢板关节融合术治疗拇指侧副韧带断裂后指间关节炎  

Treatment of interphalangeal arthritis after lateral collateral ligament rupture of thumb with miniplate arthrodesis

作　　者：张羽[1] 张红新[1] 古雪建 杨朔[1] 白晓亮[1] 连勇[1] ZHANG Yu;ZHANG Hongxin;GU Xuejian(Department of Orthopedics,The First Center Hospital of Baoding City,Baoding,Hebei,071000,China)

机构地区：[1]保定市第一中心医院骨五科,河北保定071000

出　　处：《实用手外科杂志》2021年第4期463-466,共4页Journal of Practical Hand Surgery

摘　　要：目的探讨应用微型钢板关节融合术治疗拇指侧副韧带断裂所致指间关节炎的临床疗效和手术要点。方法2015年2月-2020年1月,收治拇指侧副韧带断裂所致指间关节炎患者8例。所有患者均采用微型钢板关节融合术治疗。术后指导患者进行早期手指功能康复训练,通过X线片观察骨折愈合情况,采用疼痛视觉模拟评分(Visual Analogue Scale VAS)以及中华医学会手外科学会上肢部分功能评定标准评价手功能,并进行统计学分析。结果术后8例均获随访,所有患者伤口均一期愈合,术后约3个月骨质愈合,随访时间为6~12个月,平均10个月。患者关节VAS评分从术前(6.5±1.0)分降低至末次随访(1.5±1.0)分,差异有统计学意义(P<0.05);患手捏力从术前(3.0±2.4)kg增加至末次随访(12.5±3.5)kg,差异有统计学意义(P<0.05)。根据中华医学会手外科学会上肢部分功能评定标准:优6例,良2例。结论应用微型钢板关节融合术治疗拇指指间关节炎方法有效,可早期进行康复训练,恢复日常生活,患者满意度高。Objective To investigate the clinical effect and operative points of the treatment of interphalangeal arthritis caused by the lateral collateral ligament ruptured of the thumb by the application of microplate arthrodesis.Methods From February 2015 to January 2020,8 patients with interphalangeal arthritis were admitted to our hospital.All patients were treated with microplate arthrodesis.Patients were instructed to conduct early finger function training after surgery.The fracture healing was observed by X-ray film,the visual analogue scale VAS of pain and the upper limb function evaluation standard of hand surgery society of Chinese medical association were used to evaluate the hand function.Statistical analysis was performed.Results All 8 patients were followed up after the operation.All the patients had wound healing in stage I,and bone healing occurred about 3 months after the operation.The follow-up time was 6~12 months,with an average of 10 months.The VAS decreased from 6.5±1.0 before surgery to 1.5±1.0 at the last follow-up(P<0.05).The pinching force increased from(3.0±2.4)kg before surgery to(12.5±3.5)kg at the last follow-up,showing a statistically significant difference(P<0.05).According to the upper limb function evaluation standard of the hand surgery society of Chinese medical association:excellent in 6 cases,good in 2 cases.Conclusion It is effective to treat interphalangeal arthritis of the thumb with mini-plate arthrodesis.

关 键 词：侧副韧带 关节融合术 微型钢板 拇指 

分 类 号：R687.4[医药卫生—骨科学]