经第一掌骨基底单平面斜形截骨治疗陈旧性第一腕掌关节内骨折的临床疗效  

Clinical efficacy of single plane oblique osteotomy through the base of the first metacarpal bone in the treatment of old intra-articular fractures of the first carpometacarpal joint

作　　者：周映玲[1] 薛建波[1] 丁文全[1] 王晓峰[1] Zhou Yingling;Xue Jianbo;Ding Wenquan;Wang Xiaofeng(Department of Hand Surgery,The 6th Hospital of Ningbo,Ningbo 315040,China)

机构地区：[1]宁波市第六医院手外科,宁波315040

出　　处：《中华手外科杂志》2024年第4期299-301,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨经第一掌骨基底桡侧单平面斜形截骨治疗陈旧性第一腕掌关节内骨折的临床疗效.方法自2019年1月至2023年11月,我们对26例陈旧性第一腕掌关节内骨折患者,采用经第一掌骨基底桡侧单平面斜形截骨,下翻截骨块显露关节面骨折端,清理关节腔后纠正不平关节面骨折,复位及克氏针内固定骨折块.结果所有患者术后均获得随访,时间6~24个月,平均15个月.骨折均获得骨性愈合,愈合时间为2~4个月,平均3个月,无关节僵硬、疼痛等并发症发生,按中华医学会手外科学会上肢部分功能评定试用标准评定拇指功能:优15例,良8例,差3例,优良率为88.46%.结论经第一掌骨基底桡侧单平面斜形截骨治疗陈旧性第一腕掌关节内骨折可以获得良好的疗效.Objective To investigate the clinical efficacy of single plane oblique osteotomy through the base of the first metacarpal bone for the treatment of old intra-articular fractures of the first carpometacarpal joint.Methods From January 2019 to November 2023,26 patients with old intra-articular fractures of the first carpometacarpal joint were treated with single plane oblique osteotomy through the base of the first metacarpal bone.The fractured end of the articular surface was exposed by downward flipping of the osteotomy block,and the uneven articular surface fracture was corrected after cleaning the joint cavity.The fracture block was then reduced and fixed with Kirschner wires.Results All patients were follow-up for 6 to 24 months with an average of 15 months.The fractures all achieved bone healing,with a healing time of 2 to 4 months with an average of 3 months.There were no complications such as joint stiffness or pain.According to the upper limb functional evaluation criteria of the Chinese Society of Hand Surgery,the thumb function was evaluated as excellent in 15 cases,good in 8 cases,and poor in 3 cases,with an excellent and good rate of 88.46%.Conclusion Single plane oblique osteotomy through the radial side of the base of the first metacarpal bone can obtain good curative effect in the treatment of old intra-articular fractures of the first carpometacarpal joint.

关 键 词：腕掌关节 截骨术 陈旧性 骨折固定术 内 

分 类 号：R687.3[医药卫生—骨科学]