可吸收材料髓内固定掌骨骨折临床应用的研究

Treatment of metacarpal fractures with intramedullary absorbable implants

目的探讨运用可吸收材料髓内固定治疗第4、5掌骨中段骨折的临床疗效。方法回顾性地研究了5例(9处)第4、5掌骨中段骨折的患者,应用可吸收材料髓内固定治疗后,平均随访4．2个月,重点分析了其术后的疗效和X线片的表现。结果骨折愈合率为100％,术后无发热和非特异性皮下积液,骨折端未见短缩移位和成角畸形,掌指关节主动伸直均无障碍,主动屈曲[(80．7±9．6)°,(?)±s,下同]患手握力与健侧相比的百分率平均为94．0％。术后X线片示2～5掌骨头所连成的弧线平滑、无顿挫,髓腔内未见溶骨征象,掌骨头周围的软组织内也无肿胀影。结论采用聚L丙交酯(self-reinforced poly-l-lactide,SR-PLLA)可吸收棒进行髓内固定第4、5掌骨中段骨折,不仅方法简单,疗效较好,而且无明显的并发症。

Objective To explore the clinical results of the middle shaft fractures of the 4th and 5th metacarpi treated with intramedullary absorbable implants, Methods 5 patients with 9 fractures at the middle shaft of the 4th and 5th metacarpi were treated with intramndullary absorbable implants and followed-up with an average of 4.2 months postoperatively, The results were evaluated with respect to the clinical manifestations and Roentgen examination. Results All the patients got fracture union with no fever and subcutaneous effusion. There was no shortening, ambulatory or rotatory deformity. The active range of motion of metacarpophalangeal joint extension was fuU, while the active range of motion of metacarpophalangeal joint flexion was 80.7° ± 9.6°, Compared with the contralateral hand, grip strength of the involved hand accounted for 94.0%, Roentgen examination showed that the arch of the 2nd to the 5th metacarpal heads was smooth. There were no intramedullary lyric changes as well as soft tissue swelling. Conclusion Fractures at the middle shaft of the 4th and 5th metacarpi could be treated with intramedullary absorbable implants effectively with simple procedures and no complications.