多发性掌指骨骨折手术治疗分析

摘要

目的 探讨多发性掌指骨骨折治疗的手术方法和临床疗效.方法 自2013年12月至2015年12月,对50例多发性掌指骨骨折患者采用克氏针、钢丝、微型钢板等内固定治疗,术后指导患者早期功能康复锻炼,随访观察创面愈合、并发症发生及手外形感觉功能恢复情况.结果 术后10例创面皮肤缺损,二期植皮或者皮瓣修复创面;3例肌腱粘连,术后5个月予以手术松解,症状解除.50例均获随访,时间3~12个月,平均6个月,手部外形感觉功能恢复良好,均未出现创面感染、骨折不愈合等并发症.按关节总主动活动度(TAM)法评定手功能:本组优22例、良20例、中8例,优良率为88%.结论 手术治疗多发性掌指骨骨折,经过彻底清创、合理内固定、指导患者早期功能康复锻炼,可获得良好的手部外形、感觉和功能,安全可靠,疗效确切.%Objective To investigate the palmar surgical method and clinical efficacy of the treatment of phalangeal fractures.Methods From December December 2013 to 2015 of 50 cases of multiple metacarpal phalangeal fractures patients with grams Kirschner wire,wire,micro plate internal fixation,postoperative patients with early functional rehabilitation exercise guidance,follow-up observation were made on wound healing, complication appearance and hand feeling function recovery.Results After operation in 10 cases of skin defect,secondary skin graft or flap to repair the wound;3 cases of tendon adhesion,postoperative 5 months gives the operation release and relief of symptoms. 50 cases were followed up,3 to 12 months,with an average of 6 months,appearance of hand sensory function recovered well. There were no wound infection,osteomyelitis,nonunion of fracture. According to the total active total activity(active movement TAM)method to assess hand function:the group of excellent 22 cases,good in 20 cases,8 cases,the excellent and good rate was 88%.Conclusions Surgical treatment of metacarpal and phalangeal fractures. After thorough cleaning a,properly fixed,guiding patients with early functional rehabilitation exercise can obtain good hand shape,feel and function,safe and reliable,curative effect is exact.