关节镜辅助下经皮螺钉内固定治疗Bennett骨折

The arthroscopically-assisted percutaneous screw fixation for treating Bennett fractures

目的探讨关节镜辅助下经皮螺钉内固定治疗Bennett骨折的临床疗效、影像学结果和并发症。方法 2009年5月—2015年5月,采用关节镜辅助下经皮螺钉内固定治疗Bennett骨折患者51例(51手),其中男性40例,女性11例;年龄(38.7±12.4)岁;体重指数(23.7±8.1)kg/m2。记录并评估并发症发生率、骨折愈合时间、第一腕掌关节有效活动度评分(Kapandji Score)、握力、捏力、关节面复位及内固定移位情况等。结果 51例患者均获得随访,随访时间(33.8±9.9)个月。骨折愈合时间为(5.9±1.8)周;第一腕掌关节有效活动度评分为(9.8±0.2)分;握力为(46.7±4.2)kg;捏力为(8.7±2.4)kg。所有患者均恢复创伤前工作状态,随访期间1例(2.0%)患者出现复杂性局部疼痛综合征,但不影响日常工作。术后即刻X线片检查,所有关节面均获得解剖复位,随访检查示所有骨折均获得骨性愈合,无一例患者出现关节退变及内固定移位。结论采用关节镜辅助下经皮内固定治疗Bennett骨折,能够获得解剖复位,临床疗效和影像学结果满意,并发症发生率低。

ObjectiveTo summarize the clinical,radiographic outcomes and complications of arthroscopically assisted minimally invasive percutaneous screw fixation in treating Bennett fractures.MethodsFifty one patients(51hands)with Bennett fractures were treated by arthroscopically assisted minimally invasive percutaneous screw fixation between May2009and May2015There were40males and11females,with a mean age of(387±124)years and a mean body mass index of(237±81)kg/m2The data was recorded,including the incidence of complications,fracture union time,Kapandji Score for clinical function,grip and pinch strength,joint surface reduction,and displacement of fixation material.ResultsAll of51patients were followed up,and the mean follow up time was(338±99)months.The mean fracture union time was(59±18)weeks.The mean Kapandji Score was(98±02)points;and the mean grip and pinch strength was(467±42)kg and(87±24)kg,respectively.All patients recovered pre traumatic work activities.One patient(20%)experienced a complex local pain syndrome during follow up,but did not affect daily work.Immediate postoperative X ray images showed that all patients achieved anatomic reduction of joint surfaces.All fractures obtained bone union,and no patient had joint degeneration or displacement of screw.ConclusionThe arthroscopically assisted minimally invasive percutaneous screw fixation for Bennett fractures can achieve anatomic reduction of joint surfaces,satisfactory clinical and radiological outcomes,and a low rate of complication.