微型外固定架在手外科的新应用

The creative use of mini-external fixator in hand surgery

目的观察微型外固定架实施虎口开大术及残指延长术的临床疗效。方法 2007年4月至2011年11月,采用微型外固定架对15例虎口挛缩患者(19肢)及17例残指患者(25指)分别实施虎口开大术及残指延长术。结果所有手术均顺利完成,术后随访3～12个月,平均8个月。虎口开大患者拇指外展角度平均增加30°,拇指指间关节尺侧与示指掌指关节桡侧之间距离平均增加3cm;术后1肢发生针道感染,1肢出现第一腕掌关节半脱位。残指延长患者手指骨愈合良好,残指外形美观,血运及感觉较延长前未受到影响。结论采用微型外固定架实施虎口开大术及残指延长术安全、可靠,临床效果显著。

Objective To observe the therapeutic effects of mini external fixator in enlarging of first-web space contracture and lengthening of injured phalange. Methods From April 2007 to November 2011, 15 patients with firs〉web space eontracture at 19 sides of the hands （group 1） and 17 patients who were injured their phalange within 25 fingers （group 2） underwent the mini--external fixator aided operation. Results All operations were successful. The patients were followed up for 3 12 months （mean 8 months）. In group 1, the mean thumb abduction was increased 30 degrees. Also the mean distance between the radial side of metacarpal phalangeal joint of the index finger and the ulnar side of interphalangeal joint of the thumb was increased to 3 cm. Pin tract infection happened in one case and semidislocation of the first earpometacarpal joint occurred in the other case after operation. In group 2, all lengthened stump healed successfully and the aesthetic results were satisfactory without significant change in blood supply and feeling. Conclusions Using of mini-external flxator in enlarging of first web space contracture and lengthening of injured phalange is safe, reliable together with remarkabJe clinical effects.