克氏针弹性固定技术治疗Mallet骨折

摘要

Objective To report the surgical technique and treatment outcomes of using open reduction and Kirschner wire elastic fixation for treating Mallet fractures.Methods From May 2009 to April 2014,43 fresh Mallet fractures were treated with open reduction and Kirschner wire fixation.One K-wire kept the distal interphalangeal joint in extension and the other K-wire applied elastic compression to the fracture fragment.The wires were removed 4 to 6 weeks postoperatively when functional exercises assumed.Results Anatomical reduction of the fractures occurred in all the cases.39 patients were follow-up for 6 to 28 months (18.5 months on average).Postoperatively the treatment outcomes were evaluated by the total active motion (TAM) scale which revealed excellent results in 26 cases,good results in 11 cases and fair results in 2 cases.The overall satisfactory rate was 94.9％.Conclusion The treatment of Mallet fractures with opened reduction and Kirschner wire elastic fixation is a simple procedure that provides stable internal fixation and allows early rehabilitation.%目的 探讨切开复位克氏针弹性固定技术治疗Mallet骨折的手术方法和临床效果.方法 自2009年5月至2014年4月,我们对43例新鲜骨性锤状指Mallet骨折患者采用切开复位骨块,1枚克氏针固定远指间关节,1枚克氏针弹性扣压固定撕脱骨块治疗.术后4～6周拔除克氏针,进行功能锻炼.结果 本组患者骨折均解剖复位,骨性愈合,其中39例获得6～28个月的随访,平均18.5个月.按总主动活动度(total active movement,TAM)系统评定方法评定:优26例,良11例,可2例,优良率为94.9％.结论 切开复位克氏针弹性固定治疗Mallet骨折操作简便,固定可靠,有利于手功能恢复.