微型外固定支架治疗儿童近节指骨基底骨折

Mini External Fixator for the Treatment of Proximal Phalangeal Fracture in Children

目的 探讨微型外固定支架在儿童近节指骨基底闭合性骨折治疗中的应用和疗效。方法 自2013年5月至2016年7月,对18例儿童近节指骨基底闭合性骨折畸形患者采用微型外固定支架治疗。术后3w拆除外固定支架,指导功能锻炼。结果 平均随访6个月,所有指骨骨折愈合良好,未出现畸形愈合,未出现针道感染,关节活动度可。1例出现外架松动。根据中华医学会手外科学会上肢部分功能评定试用标准评定:优8例,良7例,可3例。结论 微型外固定支架在儿童近节指骨基底闭合性骨折治疗中疗效可靠。利用外架牵拉有助于纠正骨折畸形,避免切开手术进一步损伤骺板,影响骨质发育,避免出现手指畸形,减少关节僵硬,有助于早期进行功能锻炼。

Objective To explore the application and efficacy of mini external fixator in the treatment of closed phalangeal basal fracture in children.Methods From May 2013 to July 2016, 18 cases of children with proximal phalanx closed fracture were chosen,all of whom were treated with mini external fixator.The external fixator was removed 3 weeks after operation and patients were guided for functional exercise.Results As the average follow-up of 6 months showed, all phalanges fractures healed well, with no malunion and needle tract infection, and joint activity went well.There was 1 case with loose external frame.According to the upper extremity functional evaluation standard set by the Hand Surgery Society of Chinese Medical Association： 8 cases were excellent, 7 cases were good,and 3 cases were general.Conclusion The treatment effect of micro external fixator for children with closed fracture of the proximal phalanx base is reliable.The external frame traction helps to correct fracture deformity, avoid further injury of epiphyseal plate by incision and thereby affecting bone growth, avoid finger deformity, reduce joint stiffness, and promote early functional exercise.