桥接钢板治疗钩掌关节损伤

Bridging plate fixation for the treatment of hamatometacarpal joint injury

目的评价桥接钢板治疗钩掌关节损伤的疗效。方法回顾性分析2016年至2020年期间山东第一医科大学第一附属医院应用桥接钢板内固定治疗钩掌关节损伤的12例患者,其中男性9例,女性3例,年龄为(37±21)岁。术后6个月测量并比较患侧与健侧的腕关节活动度及手部握力。结果12例患者切口均一期愈合,未出现骨折不愈合、感染、肌腱粘连和神经损伤等并发症。虽然患侧腕关节屈伸活动度及握力与健侧比较差异均有统计学意义[(71.1±5.3)°比(76.4±6.2)°,(57.7±2.8)°比(62.1±2.7)°,(40.6±4.0)kg比(42.4±3.8)kg](均P<0.05),但患侧握力和腕关节屈伸活动度最终恢复到健侧的90%以上,并且没有明显手指或腕关节僵硬。有2例患者主诉活动时有轻度疼痛不适,3例长时间活动或劳累后有酸胀不适,但这些患者均认为不影响生活、工作。结论桥接钢板是治疗钩掌关节损伤的一种有效的方法。

Objective To evaluate the efficacy of bridging plate fixation in the treatment of hamatometacarpal joint injury.Methods A retrospective review on 12 patients treated with bridging plate fixation for hamatometacarpal joint injury was performed in The First Affiliated Hospital of Shandong First Medical University between 2016 and 2020.There were 9 males and 3 females,aged(37±21)years.Wrist range of flexion-extension motion and hand grip strength of the injured and contralateral uninjured sides were measured and compared 6 months after the operation.Results All the 12 patients healed well after the operation without fracture nonunion,infection,tendon adhesion,nerve injury,or other complications.There were statistically significant differences in the wrist range of flexion-extension motion and grip strength between the injured side and the contralateral uninjured side[(71.1±5.3)°vs.(76.4±6.2)°,(57.7±2.8)°vs.(62.1±2.7)°,(40.6±4.0)kg vs.(42.4±3.8)kg](all P<0.05).However,the wrist range of flexion-extension motion and grip strength of the injured side eventually recovered to 90%of the contralateral uninjured side,and none of the patients complained of finger or wrist joint stiffness.There were 2 patients who complained of mild pain and discomfort during activities,and 3 patients who complained of aching pain,swelling,and discomfort after prolonged activities or fatigue,but all of these patients thought that it would not affect their life and work.Conclusion Bridging plate fixation is an effective method for the treatment of hamatometacarpal joint injury.