自制“U”型钉治疗掌骨头关节内骨折

Using metallic nail for the treatment of intra-articular fracture of metacarpal head

目的 探讨应用金属“U”型钉治疗掌骨头骨折的临床疗效.方法 2008年1月-2012年2月对16例掌骨头骨折患者采用切开复位金属“U”型钉内固定方法进行治疗.术后石膏外固定3～4周,早期进行功能训练.结果 术后16例均获3～6个月随访,全部达到骨性愈合,拆除内固定后伤手的掌指、指间关节主动活动度均大于60°,未发生内固定松脱、折断及骨折畸形愈合、延期愈合等情况.手功能按TAM系统评定法评定：优14例,良2例.结论 应用金属“U”型钉内固定治疗掌骨头骨折,能恢复骨折的正常对合并维持骨折的稳定性,促进骨折的愈合,术后通过功能训练,可达功能康复.

Objective To explore the clinical effect of metallic nail （brad）for the treatment of metacarpal head fracture. Methods From January 2008 to February 2012, 16 cases with metacarpal head fracture were treated with open reduction and internal fixation of metallic nail. Postoperative plaster external fixation was in 3-4 week, and early functional training was adopted. Results 16 cases were obtained following-up for 3-6 months, all to be healed. After removing the internal fixation, the metacarpophalangeal and interphalangeal joint active motion were greater than 60 degrees, without internal fixation loosening, breaking and malunion of fracture, delayed healing. According to TAM system evaluation of hand function evaluation： excellent in 14 cases, good in 2 cases. Conclusion It can restore normal involution and maintain fracture stability, promote the healing of fracture, by using metallic nail （brad） fixation for the treatment of metacarpal head fracture.