三枚马钉联合内固定加植骨术治疗掌指骨内生软骨瘤

Application of 3 pins combined with internal fixation and bone graft to treat endochondroma in metacarpal and phalangeal bones

目的探讨应用三枚马钉联合内固定加植骨术治疗掌指骨内生软骨瘤的远期临床效果。方法2008年1月-2017年1月,对12例掌指骨内生软骨瘤患者手术治疗,在刮除瘤组织后采用三枚马钉交锁置入联合内固定加植骨术,术后石膏外固定3~4周,视肿胀情况1~2周开始行骨折远、近端关节的功能锻炼,定期随访,分析临床效果。结果术后12例均获得6~24个月的随访,全部病例在6~12个月内达到骨性愈合,拆除内固定后患手的掌指、指间关节主动活动度均大于60°,未发生内固定松脱、折断及骨畸形愈合、延期愈合等情况,手功能按TAM系统评定标准评定:优10例,良2例。结论应用三枚马钉联合内固定加植骨术治疗掌指骨内生软骨瘤,能有效恢复瘤体刮除后骨的稳定性,并促进骨的愈合,恢复手功能,远期临床效果良好。

Objective To discuss application of 3 pins combined with internal fixation and bone graft in the treatment of endochondroma in metacarpal and phalangeal bones. Methods From Jan.2008 to Jan. 2017, 12 cases of metacarpal and phalangeal endochondroma patients in treatment were treated by 3 pins fixation and bone graft surgery after curettage, postoperative plaster external fixation for 3~4 weeks, 1~2 weeks after operation, acccording to the swelling condition the distal and proximal lateral joint function exercise was performed, long-term follow-up after operation. Analyzed the clinical effect. Results After operation, 12 cases had been followed up for 6~24 months, the longest follow-up was 2 years, all cases within 6 ~12 months achieved bone healing, after removal of the internal fixation, the motion of metacarpophalangeal and interphalangeal joint were greater than 60 degrees, without internal fixation loosening, fracture and bone malunion and delayed healing, according to the TAM system evaluation criteria： excellent in 10 cases, good in 2 cases. Conclusion The application of 3 pins combined with internal fixation and bone graft in the treatment of metacarpal and phalangeal endochondroma can effectively restore the stability of the bone after curettage, promote bone healing and restore hand function. The long-term clinical effect is good.