髂骨嵴游离移植重建第1掌骨头骨缺损的效果分析  

The clinical effect of free iliac crest transplantation on the reconstruction the defect of the first metacarpal head

作　　者：黄国英[1] 刘晓春[1] 孙大炜[1] HUANG Guoying;LIU Xiaochun;SUN Dawei(Department of Traumatic Orthopedic,The Second People's Hospital of Guangdong Province,Guangzhou,Guangdong,510317,China)

机构地区：[1]广东省第二人民医院创伤骨科,广东广州510317

出　　处：《实用手外科杂志》2021年第4期476-477,499,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨利用髂骨嵴移植重建第1掌骨头骨缺损的临床疗效。方法回顾性分析2016年1月-2019年1月收治的第1掌骨头骨缺损患者15例临床资料。其中单纯掌骨头骨缺损1例,伴有伸屈肌腱损伤12例,伴有指固有动脉、神经损伤5例。患者均接受髂骨嵴游离移植第1掌骨头重建手术。结果纳入患者均获得12~18个月随访,平均(15.6±1.3)个月,伤口均一期愈合,术后无关节脱位发生。骨折愈合时间13~16个月,平均(14.1±2.5)个月,断端间均无骨吸收。与健侧外观对比,长度伸长1~6 mm,平均(3.4±0.8)mm。临床优良率评价:优8例,良5例,差2例,优良率86.7%。根据TAM评价:优10例,良4例,差1例,优良率93.3%。结论采用髂骨嵴游离移植重建第1掌骨头骨缺损具有操作简单,并发症少,重建后功能、外观良好,供区创伤较小等优点,值得临床推广应用。Objective To investigate the clinical effect of free iliac crest transplantation on the reconstruction the defect of the first metacarpal head.Methods From January 2016 to January 2019,15 patients with defect of the head of the first metacarpal bone admitted to our department were reviewed.One patient had simple metacarpal head defect,12 patients had extensor tendon injury,and 5 patients had digital proper artery and nerve injury.The first metacarpal head reconstruction was performed after free iliac crest transplantation.Results All patients were followed up for 12-18 months,with an average of(15.6±1.3)months.The wounds of all patients healed in one stage,and no postoperative dislocation occurred.The healing time of fracture was 13-16 months,with an average of(14.1±2.5)months.Compared with the appearance of the healthy side,the length is extended 1~6 mm,with an average of(3.4±0.8)mm.Clinical excellent and good rate evaluation:excellent in 8 cases,good in 5 cases,poor in 2 cases,the excellent and good rate was 86.7%.According to TAM evaluation,10 cases were excellent,4 cases were good and 1 case was poor,with an excellent and good rate of 93.3%.Conclusion Free iliac crest transplantation for the reconstruction of the first metacarpal head has the advantages of simple operation,fewer complications,good function and appearance after reconstruction,and less trauma in donor site,which is worthy of clinical application.

关 键 词：髂骨嵴 第1掌骨头 骨缺损 骨重建 

分 类 号：R687.3[医药卫生—骨科学]