AO微型钛板结合同种异体骨治疗掌指骨粉碎性骨折

AO micro-titanium combined with allograft bone in treating comminuted metacarpal and phalanx fractures

目的:探讨AO微型钛板结合同种异体骨移植治疗伴骨缺损的掌指骨粉碎性骨折的治疗效果。方法:2004年3月至2008年1月,应用AO微型钛板结合同种异体骨移植治疗伴骨缺损的掌指骨粉碎性骨折30例38指,术后早期功能锻炼及康复指导。结果:术后30例中24例伤口一期愈合,4例发生伤口红肿渗出,拆除部分缝线引流换药后愈合,2例发生皮肤软组织坏死钢板外露,经皮瓣修复后创口闭合。X线片显示骨折愈合时间为6～12周,平均8周。术后随访6个月～3年,按中华医学会手外科学会手部功能评定标准,优22例,良5例,可2例,差1例,优良率90%。结论:AO微型钛板结合同种异体骨移植治疗伴骨缺损的掌指骨粉碎性骨折临床效果良好。

Objective ： To explore the effects of using AO micro-plate and allograft bone to treat the comminuted metacarpal and phalanx fractures with bone defects. Methods：From March 2004 to January 2008, we used micro-AO plate and allograft bone to treat 38 comminuted metacarpal and phalanx fractures with bone defect. The patients were allowed to begin flexion and extension of the injured joint on the fourth day after surgery. Results ：24 in 30 patients healed, 4 patients were infected and they healed finally by drainage and changed of the dressing：2 plates were exposed because of skin and soft tissue necrosis, then the wounds were closed with flaps. X-ray showed that the time of fracture healing was 6-12 weeks, with an average of 8 weeks. After following-up 6 months -3 years, according to the Chinese Medical Association of Hand Surgery Institute of hand function evaluation standards, the hands function was excellent in 22 patients, good in 5 patients, ordinary in 2 patients, poor in 1 patient, with the good rate of 90. Conclusion： Good hand function can be achieved by using AO mini-plate and allograft bone to treat the comminuted metacarpal and phalanx fractures with bone defects.