应用微型钢板治疗掌骨骨折

Application of miniature steel plate in treatment of metacarpal fracture

目的探讨微型钢板治疗掌骨骨折的方法 ,评价其对掌骨骨折的治疗效果。方法 65例(76处)掌骨骨折患者为研究对象,均采用骨折切开复位微型钢板螺钉内固定治疗,术后早期进行功能锻炼。对术后掌指关节活动度、骨折愈合情况进行评价。结果 65例(76处)骨折均得到随访,随访时间2~12个月,X线片示骨折愈合时间3~4个月,均达骨性愈合。术后6~12个月取出内固定,根据手指总主动活动度(TAM)评分,65例患者中61例为优良,优良率为93.8%,疗效满意。结论采用微型钢板螺钉内固定治疗掌骨骨折,操作简便,术野暴露清楚,固定牢固,方式灵活多样,特别是治疗关节内骨折,术后能早期功能锻炼,缩短骨折愈合时间,疗效优于传统治疗方法 ,值得推广应用。

Objective To explore the method of miniature steel plate in treatment of metacarpal fracture, and evaluate its therapeutic effect for metacarpal fracture. Methods A total of 65 metacarpal fracture patients（76 sites） as study subjects all received open reduction and internal fixation with miniature steel plate and screws for treatment, and early postoperative functional exercise. Evaluation were made on postoperative metacarpophalangeal joints activity and fracture healing situation. Results All 65 cases（76 sites） were followedup for 2-12 months, and X-ray film showed that fracture healing time was 3-4 months. All patients had bony union, and internal fixation was removed in 6-12 months after operation. According to finger total active motion（TAM） score, there were 65 excellent and good cases, with excellent-good rate as 93.8%, and the curative effect is satisfactory. Conclusion Internal fixation with miniature steel plate and screws provides better curative effect for the treatment of metacarpal fractures than traditional treatment Methods, and it has simple operation, clear operative field, firmly fixation, flexible mode. Especially for the treatment of intra-articular fractures, it can put postoperative functional exercise ahead and shorten fracture healing. So it is worthy of popularization and application.