自体骨植骨结合微型钢板治疗掌指骨粉碎性骨折

摘要

目的：探讨应用自体骨植骨结合微型钢板治疗掌指骨粉碎性骨折的临床疗效。方法对51例58处骨折(掌骨骨折37例43处，指骨骨折14例15处)分别行切开复位、微型钢板内固定结合自体骨植骨手术治疗。结果所有患者术后随访4～12个月，切口均一期愈合，骨折均解剖复位、骨性愈合，无旋转及成角畸形，关节活动范围佳。根据TAF评分，优40例，良8例，差3例，优良率为94.1％。结论对于复杂的伴有骨缺损的掌指骨粉碎性骨折，应用自体骨植骨结合微型钢板治疗具有成骨能力强、无免疫排斥反应、固定牢固可靠、早期功能锻炼等优点，疗效确切可靠。%Objective To evaluated the clinical efficacy of autogenous bone graft and Mini-plate fixation in the treatment of metacarpal and phalangeal fractures. Methods The study included 58 fractures in 37 patients (43 metacarpal fractures in 37 patients, 15 phalangeal fractures in 14 patients). Open reduction, autogenous bone graft and Mini-plate fixation were performed in all patients. Results Union was obtained in all the patients after 4~12 months. All patients obtained primary healing of incision, fracture anatomical reposition, osseous healing and good joint activities without rotation and angular deformity. At final assessments, TAF showed excellent, good, and poor results in 40, 8 and 3 cases, respectively. An excellent and good TAF was obtained in 48 cases (94.1%) treated with autogenous bone graft and Mini-plate fixation. Conclusion For the complex metacarpal and phalangeal fractures associated with bone defects, autogenous bone graft and Mini-plate fixation are useful and reliable for treatment of such injuries. Our method provides firm fixation and early functional exercise without immunological rejection.