微型钛板跨关节固定治疗CainⅢ型钩骨骨折  

Treatment of cainⅢhamate fracture by using mini-titanium plate with cross-articular fixation

作　　者：韩文龙[1] 王晓乐[1] 李腾 陈坤峰[1] 赵志坚[1] HAN Wenlong;WANG Xiaole;LI Teng(Department of Trauma Surgery,The First People's Hospital of Shangqiu,Shangqiu,Henan,476000,China)

机构地区：[1]商丘市第一人民医院急诊创伤外科,河南商丘476000

出　　处：《实用手外科杂志》2023年第1期94-96,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨微型钛板跨关节固定治疗CainⅢ型钩骨骨折的临床效果。方法对2017年7月-2020年8月收治的7例CainⅢ型钩骨骨折患者采用微型钛板跨关节固定治疗。术中均采用腕掌关节背侧入路显露,骨折复位后将微型钛板跨腕掌关节放置于掌骨近端和钩骨的背侧,以固定钩骨骨折和腕掌关节脱位。术后采用Mayo腕关节评分、疼痛视觉评分(VAS)、手部握力及环小指总主动活动度(Total active motion,TAM)评价,同时定期复查腕关节X线片。结果7例患者均获8~40个月随访,平均(15±6)个月;骨折均愈合,时间为7~11周,平均(8.5±1.6)周。所有患者的内固定物均于术后5~7个月取出。末次随访,无1例发生创伤性关节炎、感染、神经损伤;有1例肌腱粘连给予热敷、锻炼后恢复。结论采用微型钛板跨关节固定治疗CainⅢ型钩骨骨折,能够解剖复位骨折,固定牢靠,有助于维持复位,术后可早期功能训练,骨折愈合及功能良好,是治疗CainⅢ型钩骨骨折有效手术方法。Objective To investigate the clinical efficacy of cainⅢhamate fractures by using plates with cross-articular fixation.Methods From July 2017 to August 2020,7 patients treated by using plates with cross-articular fixation were collected.The dorsal approach of the carpal-metacarpal joint was used to expose.After reducing the fractures,a miniature titanium plate was placed across the carpal-metacarpal joint on the proximal end of the metacarpa and the dorsal side of the hamate to fix the hamate fractures and dislocation of the carpal-metacarpal joint.The Disabilities of the ARM,the visual analogue scale of pain(VAS),the Mayo wrist score,the grip strength of both hands and the total active motion(TAM)of the ring finger and the little finger were used to evaluate the postoperative function of wrists.The wrist X-rays were reviewed regularly.Results Seven patients were followed up for 8-40(15±6)months.Till the last follow-up time,all the hamate fracture healed completely.The healing time was 7-11(8.5±1.6)weeks.All internal fixation was removed from 5 to 7 months postoperative.None of the patients had any traumatic arthritis,infection or nerve damage.One patient with tendon adhesions had recovered by hot compress and exercise.Conclusion This method of using micro-titanium plate with cross-articular fixation to treat CainⅢhamate fracture can get anatomical and stable reduction and early motion,which can also get reliable healing and function.It is an effective treatment for CainⅢhamate fractures.

关 键 词：钩骨 骨折 跨关节固定 腕掌关节 

分 类 号：R687.3[医药卫生—骨科学]