3D微型钢板内固定治疗掌指骨骨折的近期疗效观察

3D mini-plate internal fixation for treaUnent of metacarpal and phalangeal fractures： a short-term follow- up study

目的分析3D微型钢板内固定治疗掌、指骨骨折的近期临床效果。方法对33例35处掌、指骨骨折的患者，其中掌骨骨折20处、近节指骨骨折15处，采用切开复位背侧3D微型钢板内固定，术后1周开始功能锻炼，合并肌腱断裂者术后3周开始功能锻炼。结果术后全部患者获得3～9个月随访，无钢板断裂，全部骨折均顺利愈合，愈后外观无明显成角和旋转畸形。按手指关节总活动度（TAM）评定标准评分：优18处，良14处，可3处；优良率为91．4％。结论3D微型钢板内固定治疗移位掌指骨骨折，可提供双平面及多方位牢靠的固定，尤其适用于粉碎性骨折及纵形骨折，有助于早期功能锻炼，是一种理想的内固定方法。

Objective To analyze the short term clinical results of 3D mini-plate internal fixation for the treatment of metacarpal and phalangeal fractures. Methods Thirty-three patients with 35 metacarpal and phalangeal fractures were treated with open reduction and 3D mini-plate fixation via a dorsal approach. There were 20 metacarpal fractures and 15 proximal phalanx fractures. Functional exercise started 1 week after the surgery in patients with fracture fixation only, and 3 weeks postoperatively in patients with combined tendon repair. Results All the patients were follow-up for 3 to 9 months. There was no plate fracture. All the fractures healed uneventfully. There were no obvious angular or rotational defomfities. Rated by the total active range of motion （TAM） system, finger functions were excellent in 18 cases, good in 14 cases and fair in 3 cases, with an overall satisfactory rate of 91.4%. Condusion 3D mini-plate provides dual-plane, multi-faceted firm fixation of metacarpal and phalangeal fractures with displacement. It is particularly suitable for unstable fractures such as eomminuted fractures and longitudinal fractures. It facilitates early functional exercise and is an ideal intemal fixation method.