自制竹弓牵引架治疗近节指骨粉碎性骨折临床疗效观察

Clinical observation of self-made bamboo bow traction frame in the treatment of comminuted fracture of proximal phalanx

目的:探讨自制竹弓牵引架治疗近节指骨粉碎性骨折的治疗技巧及分析其临床疗效。方法:回顾性分析自2016年1月-2016年12月,采用自制竹弓牵引架对60例近节指骨粉碎性骨折进行微创治疗;男42例、女18例:年龄35~55岁,中位数44岁。骨折位于左手22例、右手38例;单指骨折44例,两指及两指以上骨折16例。受伤至手术时间1~10d,中位数2d。术后随访观察骨折愈合、并发症发生及手指功能恢复情况。结果:所有患者均获得随访,随访时间3~12个月,中位数6.5个月。骨折均愈合,愈合时间4~5周,中位数4周。屈指时指尖均可触及掌横纹,手指关节伸直均达0°,握持物有力。按照美国手外科学会制定的手指关节总活动度评定标准评定疗效,优47例、良11例、可2例,优良率96.7%。均无针孔感染等并发症发生。结论:采用自制竹弓牵引治疗近节指骨粉碎性骨折,具有操作简单、骨折愈合率高、手指功能恢复好、并发症少等优点,值得临床推广应用。

Objective:To explore the treatment skills and analyze the clinical curative effect of self-made bamboo bow traction frame in the treatment of comminuted phalanx fractures of the proximal phalanx.Methods:Retrospective analysis:From January 2016 to December 2016,60 cases of comminuted phalanx fractures were treated with self-made bamboo bow traction frame;42 males and 18 females:aged 35-55 years old,the average was 44 years old.The fracture was located in 22 cases of left hand and 38 cases of right hand;44 cases of single finger fracture,16 cases of two fingers and more than two fingers.Injury to surgery time was 1 d to 10 d,averaged 2 d. Fracture healing,complications,and recovery of finger function were observed after follow-up.Results:All patients were followed up for 3 to 12 months with an average of 6.5 months.The fractures healed and the healing time was 4 to 5 weeks with an average of 4 weeks.When the finger was flexed,the fingertips could touch the palm stripes,and the finger joints reached 0°,and the grip was powerful.According to the standard of total activity of finger joints developed by the American Society of Hand Surgery,the results were excellent in 47 cases,good in 11 cases,and fair in 2 cases.The excellent and good rate was 96.7%.No complications such as pinhole infection occurred. Conclusion:The application of self-made bamboo arch traction for the treatment of comminuted fractures of the proximal phalanx had the advantages of simple operation,high fracture healing rate,good finger function recovery and less complications.It was worthy of clinical application.