持续骨牵引复位在近节指骨干骨折微创治疗中的临床应用

Clinical application of continuous traction reduction in minimally invasive treatment of proximal phalanx fracture

目的 探讨持续骨牵引复位在近节指骨干骨折微创治疗中的临床效果。方法 2019年6月-2021年3月,在近节指骨干骨折微创治疗中,将中节指骨远端横行钻入一枚直径1.2 mm的克氏针,用消毒绷带绕过克氏针接重锤行持续牵引,复位近节指骨骨折。C型臂机透视确定骨折复位满意后闭合穿入克氏针固定骨折端。结果 本组20例27指全部得到随访,随访时间6~12个月,所有病例均骨性愈合,无旋转畸形或成角畸形,应用中华医学会手外科学会上肢部分功能评定试用标准行手指关节总活动度(TAM)评分,优16例20指,良4例7指,优良率100%。结论 手指近节指骨干骨折采用经皮穿克氏针内固定,可以获得较好的临床疗效,持续牵引复位在微创治疗中具有复位便捷、利于精准穿针的良好作用,值得临床推广应用。

Objective To explore the clinical effect of continuous traction reduction in minimally invasive treatment of proximal phalanx fracture. Methods From June 2019 to March 2021, the Kirschner wire with diameter of 1.2 mm was drilled into the distal end of the middle phalanx in a transverse direction, and then the sterilized bandage was used to bypass the Kirschner wire and hammer for continuous traction to reduce the fracture of the proximal phalanx. The fracture end was closed and fixed with Kirschner wire after the satisfactory reduction was confirmed by C-arm fluoroscopy. Early functional exercise was instructed after operation. Results All 20(27) cases were followed up for 6 months to 1 year. The fractures of 20(27) patients were bony union without rotation or angular deformity. The total activity of the finger joint(TAM)was evaluated by the upper limb function evaluation standard of the hand surgery society of the Chinese Medical Association. 16(20) cases were excellent, 4(7) cases were good, and the excellent and good rate was 100%.Conclusion Through percutaneous Kirschner wire internal fixation, the fracture of proximal phalanx shaft can obtain better clinical effect. Continuous traction reduction plays a good role in the process of minimally invasive treatment, which is convenient for reduction and is conducive to accurate needling, and is worthy of clinical application.