微型钛板螺钉在四肢骨折中的临床应用

Clinical application of miniature titanium plating screw for lmbs bone and joint fracture

目的 探讨与评价微型钛板螺钉在四肢短骨、关节骨折中的临床应用疗效.方法 回顾性分析2004年2月-2013年6月,采用Medicon微型钛板螺钉切开复位内固定治疗四肢骨关节骨折病例,其中掌指骨骨折60例（93处）、跖趾骨骨折37例（62处）,桡骨小头骨折15例,腕舟状骨骨折9例,关节内撕脱骨折尺骨冠状突骨折4例,髌骨4例,股骨髁3例.术后早期行主被动功能锻炼.结果 手足组：术后随访4 ～12个月,骨折愈合时间8～12周,优78例,良66例,差11例,优良率为92.9％;桡骨头骨折组：随访6个月～1年均骨性愈合,按改良法Cassebaum评分评定,优良率93.3％;腕舟骨骨折组：采用改良Mayo法对腕关节功能进行评估,优良率88.9％;尺骨冠状突骨折4例,髌骨4例,股骨髁3例,均全部愈合,且关节功能佳,优良率100％.结论 微型钛板、螺钉内固定治疗手足指掌骨、趾跖骨骨折,能达到解剖复位、控制旋转、防止畸形发生并能在骨折端维持加压作用,是较理想的内固定材料;对四肢大关节内撕脱游离骨折复位精确,对关节面损伤小、固定满意,也可适当选择应用.

Objective To study and evaluate mini-titanum-plates the effects applied to four limbs bone and joint fracture.Methods 132 patients in our hospital suffered from four limbs fractures treated with open reduction internal fixation of Medicon mini-plate from February 2004 to June 2013 were studied retrospectively,including 60 cases of metacarpal and phalanx fracture（93 lesions）,37 cases of metatarsal and phalanx fracture（62 lesions）,15 cases of radial head fracture,9 cases of scaphoid fracture,4 cases of coronoid process of ulna fracture,4 cases of patella frature,3 cases of condyles of femur.Results Clinical outcomes：hands and feet group：follow-up postoperative 8-12 months,evaluation results showed that excellent was 78cases,good was 66cases,poor was 11cases,good rate was 92.9%.group of radius head fracture：Fractures got osteal union after 6 months to 1 year.good rate was 93.3%.group of scaphoid bone fracture：Fractures got osteal healing.all cases adopt improved Mayo Evaluation Wrist Function to evaluate,good rate was 88.9%.Including 4 cases of Coronoid process of ulna fracture,4 cases of patella fracture,3 cases of femoral condylar fracture,the excellent good rates was 100%.Conclusions Metacarpal and metatarsals phalanx fracture treated with mini-plate can get reduction anatomically,control rotation,prevent malformation and keep compression,they are the ideal internal fixation material;free fragments for intra-articular fracture fixed by mini-titanum-plate and screws can get reduction precisely,be fixed satisfactory,also can choose the appropriate application.