近节指骨干骨折手法整复后James内在肌阳性位及阻挡伸指位石膏制动的临床疗效  

Manipulation of james’ internal muscle positive and fixation of proximal finger shaft fracture

作　　者：孙洋[1] 彭源[1] 甘远强 SUN Yang;PENG Yuan;GAN Yuanqiang(Department of Orthopedics,Guizhou Provincial Armed Police Force Hospital,Guizhou,Guiyang,550005,China)

机构地区：[1]武警贵州总队医院外1科,贵州贵阳550005

出　　处：《实用手外科杂志》2022年第2期218-220,223,共4页Journal of Practical Hand Surgery

摘　　要：目的 探讨近节指骨干骨折手法整复后使用James内在肌阳性位及阻挡伸指位石膏制动的临床疗效分析。方法 对2014年11月-2021年1月收治的60例指骨干骨折患者麻醉后手法整复骨折,纠正短缩、矢状面成角,内外旋纠正旋转,纠正骨折向掌侧成角,相邻手指胶带固定,对照组石膏夹板James内在肌阳性位固定,观察组在James内在肌阳性位固定两周后改为阻挡伸指位背侧石膏托制动。两组石膏固定当天、1周、2周、4~5周、4~6个月复查X线片。记录6个月TAM系统评分、患指捏力、骨折愈合时间。结果 两组所有患者均完成随访,均未出现畸形愈合、骨不愈合、皮肤坏死等并发症。两组患者TAM比较,观察组优良率93.33%,对照组优良率73.33%,差异有统计学意义(P<0.05);伤指捏力情况对比,观察组优良率90%,对照组优良率66.67%,差异有统计学意义(P<0.05);观察组与对照组骨折愈合时间,差异无统计学意义(P>0.05)。结论 手法整复近节指骨骨折后采用James内在肌阳性位固定两周后改为阻挡伸指位石膏位固定近节指骨干骨折效果可靠有效。Objective To investigate the effect of plaster immobilization in James’internal muscle positive position and blocking finger position on proximal finger shaft fracture.Methods After anesthesia,the shortening and sagittal angle of the fracture were corrected by manipulative reduction,and the rotation was corrected by internal and external rotation.The fracture was corrected to the palmar angle,fixed by the finger tape,and fixed by the James internal muscle positive position of the plaster splint.After 2 weeks,the observation group was changed to block the extension of the finger position,and the back side of the plaster bracket was braked to actively buckle the interphalangeal joint.X-ray examination was performed on the day of plaster fixation,1 week,2 weeks,4~5 weeks and 4~6 months.TAM system score,finger pinching force and fracture healing time were recorded for 6 months.Results All patients in two groups were followed up,and no complications such as malunion,nonunion or skin necrosis occurred.TAM comparison between two groups:the excellent and good rate of the observation group was 93.33%,and that of the control group was 80%,(P<0.05);the excellent and good rate of the observation group was 90%,and the excellent and good rate of the control group was 73.33%,(P<0.05),there was no significant difference in fracture healing time between the observation group and the control group (P>0.05).Conclusion Manua reduction of proximal phalanx fractures James internal muscle positive position,extension position block gypsum treatment of proximal phalanx fractures is reliable and effective.

关 键 词：近节指骨 阻挡伸指位 James内在肌阳性位 

分 类 号：R687.3[医药卫生—骨科学]