排筏外固定架治疗指骨严重粉碎性骨折  

Raft external fixation device for phalanx serious comminuted fractures

作　　者：刘应良 江长海 赵正科 谢科 李江 双志仁 赵晓祥 陆俊奇 刘燕军 LIU Yingliang;JIANG Changhai;ZHAO Zhengke(Department of Orthopedics,The People's Hospital of Chuxiong Yi Autonomous Prefecture,Chuxiong Yi Autonomous Prefecture,Yunnan,675000,China)

机构地区：[1]楚雄彝族自治州人民医院骨二科,云南楚雄彝族自治州675000 [2]楚雄彝族自治州人民医院科教科,云南楚雄彝族自治州675000 [3]楚雄医药高等专科学校,云南楚雄彝族自治州675000 [4]楚雄彝族自治州人民医院骨一科,云南楚雄彝族自治州675000

出　　处：《实用手外科杂志》2022年第4期450-453,共4页Journal of Practical Hand Surgery

基　　金：楚雄医药高等专科学校科研项目(项目编号:2021YYXM02)。

摘　　要：目的报道一种自制外固定架(排筏外固定架)在治疗指骨严重粉碎性骨折中的临床应用和疗效。方法2016年5月-2019年11月,收治难治性指骨严重粉碎性骨折11例13指,均采用自制外固定架治疗,术后采用手指总主动活动度(TAM)对手功能进行评价。结果所有患者术后创口顺利愈合,无皮肤坏死等并发症,10例12指获12~54个月的随访,平均35.2个月,1例失访。术后固定稳妥,无松动、骨折复位丢失、固定失效、针道感染等并发症,骨折全部愈合,愈合时间5~16周,平均10周。手功能采用手指总主动活动度(TAM)法评定:优6指,良3指,可2指,差1指,优良率75%。结论排筏外固定架是治疗难治性指骨严重粉碎性骨折的一种良好方法,置入及固定方法便捷,有利于皮肤软组织保护,可早期康复训练,取出方便,功能恢复良好,费用低廉,值得临床推广应用。Objective To report the clinical application and efficacy of raft external fixation device for phalanx serious comminuted fracture.Methods From May 2016 to November 2019,11 patients with 13 refractory phalanx serious comminuted fractures were involved.All cases were treated by raft fixation device.The postoperative outcomes were evaluated by the total active movement(TAM)scale.Results The incisions in all patients healed smoothly,no complications of skin necrosis occurred.Twelve fingers of Ten patients were followed up for 12 to 54 months(mean 35.2 months).One case lost follow up.The fixations were stable after operation.No complication of device loose,loss of fracture reduction,pin-track infection occurred.All fractures healed among 5 to 16 weeks(mean 10 weeks).The postoperative outcomes were evaluated by the total active movement(TAM)scale.The result were rated as excellent in 6 fingers,good in 3 fingers,fair in 2 fingers and bad in 1 finger,the overall satisfactory rate was 75%.Conclusion Raft external fixation device is a good satisfactory methods for refractory phalanx serious comminuted fractures.The method of placement and fixation is convenient.It is good for skin and soft tissue protection,can carry out early rehabilitation activities,is easy to take out,finger function is good and the cost is economical.It is worthy of clinical promotion and application.

关 键 词：指骨 骨折 治疗 外固定架 

分 类 号：R658.2[医药卫生—外科学]