活动性并指固定治疗手部掌指关节缺损

Metacarpophalangeal joint defects of hand treated by moving syndactyl fixation

目的报道利用伤指邻近的正常手指作为生理性外固定支架与伤指并指固定，应用带血供的掌骨近端骨块修复２～５掌指关节缺损的效果。方法以掌背动脉为轴心，设计逆行掌骨近端关节面修复掌指关节缺损，用１或２枚克氏针将伤指与相邻正常手指横行贯穿固定，保持各关节的自由活动，术后早期功能锻炼，７周左右拆除克氏针。结果治疗２～５掌指关节缺损１１例获得成功，修复后的掌指关节对位对线好，关节间隙存在，术后１～３个月关节活动接近正常，皮瓣全部成活。结论该方法在修复２～５掌指关节缺损中具有简化手术，就地取材，损伤小，骨折固定可靠，便于早期功能锻炼，缩短疗程。

Objective To report the result of the defects of metacarpophalangeal joint from 2 to 5 repaired by metacarpal articular surface with dorsal metacarpal artery and using Kirschner pins to transfix the injured finger and the nearby normal finger Methods It was designed that reverse articular surface of metacarpal by using the dorsal metacarpal artery as the axis and used one or two Kirschner pins to transfix the injured finger and the nearby normal finger for treating metacarpophalangeal joint defects, keeping the free motion of every joint, then early functional exercises was made after the surgery and the needle was pulled about 7 weeks Result Eleven cases were applied successfully, the repaired bone and joint showed normal position and bone union without narrowing of joint space by the X ray films the average range of motion of the joints was almost normal after the operation for 1 to 3 months, all transplanted tisssues survived Conclusions Repairring the defects of metacarpophalangeal joint from 2 to 5 with this method was able to obtain a simple operation, taking materials of what was there, a little injury, stable fix for fracture, short treatment course and exercising early after the operation and promote healing of fracture