改良动力牵引外固定器治疗近指间关节内骨折/脱位

Treatment of intra-articular fracture or dislocation of the proximal interphalangeal joint by modified dynamic traction external fixator

目的 研究改良克氏针-橡皮筋动力牵引外固定器在近指间关节内骨折/脱位中的应用。方法 自2014年1月至2017年6月,我们应用改良克氏针-橡皮筋动力牵引外固定器,在C臂机引导下闭合复位治疗近指间关节内骨折/脱位患者23例32指。结果 术后8~12周达到骨折临床愈合,关节功能得到最大程度恢复,随访3~15个月,未见明显粘连、关节僵硬等并发症。采用TAM法评定功能:优19例,良4例。结论 改良克氏针-橡皮筋动力牵引外固定器精巧、简便,治疗近指间关节内骨折/脱位术中不产生医源性血运破坏,有利于骨折愈合,支持早期功能锻炼,最大限度保护关节功能,且闭合复位能促进骨折早期愈合。

Objective To study the application of modified dynamic Kirscfiner wire-rubber traction external fixator in the treatment of intra-articular fracture or dislocation of the proximal interphalangeal joint.Methods From January2014to June2017,23patients(32fingers)with intra-articular fracture or dislocation of the proximal interphalangeal joints were treated by modified dynamic Kirschner wire-rubber traction external fixator after closed reduction under C arm X ray machine guidance.Results After 8to12weeks,the fractures healed and the joint fimction recovered to the greatest extent.All the patients were follow-up for3to15months.No obvious complications such as adhesion and joint stiffness occurred. According to TAM functional evaluation,the results were graded as excellent in19cases and good in4 cases.Conclusion The modified dynamic Kirschner wire-robber traction extemal fixator is exquisite and simple.It does not produce iatrogeuic blood supply damage during the treatment of intra-articular fracture or dislocation of the proximal interphalangeal joint.It is conducive to fracture healing,supports early functional exercise,protects joint function to the greatest extent,and closed reduction can promote early tincture healing.