L形切口在远节指骨近端骨折的临床应用

The clinical application of L incision in proximal fracture of the distal phalanx

目的探讨"L"形切口在远节指骨近端骨折应用的临床效果。方法 2015年6月-2017年5月,采用"L"形切口治疗闭合性手指远节指骨近端骨折18例,其中伸肌腱止点撕脱骨折14例,基底部骨折4例。结果术后14例伤口无感染、无皮肤坏死,4例患指皮瓣出现少量瘀血,未给予处理,伤口2周拆线,伤口均Ⅰ期愈合。所有患者获得随访,时间为2～6个月,平均3.6个月,患指无红肿,指背皮肤瘢痕不明显,外观满意,1例患指出现指甲不平整,手指伸屈功能恢复良好,根据中华医学会手外科学会上肢部分功能试用标准评定:优14例,良4例。结论 "L"形切口治疗闭合性手指远节指骨骨折,术中显露充分,术后患指指背皮肤未见明显瘢痕,外观满意。

Objective To explore the clinical effect of L incision application on the proximal fracture of distal phalanx. Methods From June 2015 to May 2017 we used L incision in the treatment of proximal closed fractures of distal phalanx in 18 cases, including 14 cases of extensor tendon avulsion fracture, 4 cases of basal fracture. Results Fouteen cases had no postoperative wound infection, or skin necrosis, 4 cases of finger skin had congestion, not given of treatment, wound stitches were removed 2 weeks later, wound obtained primary healing. All patients were followed up for 2-6 months, with the average of 3.6 months, without swelling, dorsal skin scars were not obviouse, appearance was satisfactory, 1 finger nails was uneven, finger flexion function recovered well, according to the Chinese Medical Association of hand surgery to the upper extremity function criteria： excellent in 14 cases, 4 cases were good. Conclusion The L - shaped incision to treat closed distal phalangeal fractures can be exposed fully, postoperative digital dorsal skin has no obvious scar, appearance is satisfactory.