Objective To introduce the clinical application results and surgical technique in the treatment of fracture-dislocation of the hamate-metacarpal articulation with across-joint internal fixation using the bridging plate technique. Methods From August 2008 to December 2015, 55 cases of fracture-dislocation of the hamate-metacarpal articulation were treated with this kind of method and followed up. According to Cain type, there were 8 cases of type I A, 27 cases of type I B, 13 cases of type Ⅱ and 7 cases of type Ⅲ. Open reduction and across-joint internal fixation were performed on fracture-dislocation of the hamate-metacarpal articulation using a 2.3mm Stryker bridging plate, as well as fixation of the 4th and 5th carpometacarpal joint. Early motion was allowed after the operation. The plate was removed at 4 months after the operation. Results All the cases were followed up for an average period of 2.5 years ( range: 6 - 48 months ). Fracture union was achieved successfully in all the cases, and the average union time was 5.5 weeks. Function evaluation was made according to pain degree and flexor and extensor activity of the wrist joint. There were 39 excellent cases, 14 good cases, 2 fair cases and 0 poor case. The overall excellent and good rate was 96.3%, and the clinical results were satisfactory without severe complications or recurrence of dislocation. Conclusions Treatment of fracture-dislocation of the hamate-metacarpal articulation with across-joint internal fixation using the bridging plate technique is better than conventional methods. This technique avoids redislocation and instability of the hamate-metacarpal joint. It is allowed to begin early active motion of the wrist joint, and meanwhile strong and stable fixation can be achieved. Postoperative joint pain can be relived and limited joint activity can be avoided. It is an effective method in treatment of fracture-dislocation of the hamate-metacarpal articulation.%目的 介绍应用跨关节桥接钢板内固定技术治疗钩骨-掌骨关节骨折背侧脱位的手术技术及疗效.方法 2008年8月至2015年12月,应用跨关节桥接钢板内固定技术治疗55例钩骨-掌骨关节骨折背侧脱位患者.采用Cain分型,其中I A型8例,I B型27例,Ⅱ 型13例,Ⅲ型7例.应用2.3 mm Stryker微型直钢板,切开复位钩骨-掌骨关节骨折背侧脱位并跨钩骨和4,5腕掌关节固定,手术后行早期功能锻炼.术后4个月去除钢板.结果 术后所有患者获随访6~48个月,平均2.5年.55例骨折均顺利愈合,愈合时间平均5.5周.术后疼痛程度和关节活动度评价,优39例,良14例,可2例,差0例,优良率为96.3%.术后未发生严重并发症和脱位复发.结论 应用跨关节桥接钢板内固定技术治疗钩骨-掌骨关节骨折背侧脱位,复位固定可靠,允许早期关节活动,无术后脱位复发和关节不稳定的风险,有效降低术后关节疼痛和关节活动受限,是治疗钩骨-掌骨关节骨折背侧脱位的有效方法.
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