手掌指骨折AO微型钛金属板内固定临床应用

Clinical application of AO titanium micro-plate in treatment of metacarpal and phalanx fractures

目的 针对不同部位的掌、指骨骨折而采用不同类型的AO微型钛金属板进行内固定治疗,探讨骨折的愈合特点及肌腱与钛金属板的相互关系,为手部的早期功能康复提供确切的治疗依据。方法针对不同部位的掌、指骨骨折,采用指背的弧型或S型切口,沿伸指肌腱正中纵行切开显露骨折,复位后根据骨折的具体类型,选择AO微型钛金属板、钛螺钉固定。结果 临床应用76例病员,83处骨折其中29处为通关节骨折。术后15d TAM法骨折临床愈合时间4～8周,平均5周,68例随访3个月以上,TAM法优良率达89.8％,远期优良率100％。结论 AO微型钛金属板治疗手部指骨骨折,固定确切,诸多复杂骨折均可达到解剖或近解剖位。手术操作不复杂,能术后第1天即可开始功能训练,能有效预防手掌、指部肌腱粘连,功能恢复满意。

Objective To investigate different types of AO titanium micro-plates in treatmeni of different types of metaearpal and phalanx fractures,tint! the relationship between fracture healing and the.plate so as to provide definite evidence for early hand functional recovery.Methods We first chose curve-type or S-type incision according to various sites of metacarpal and phalanx fractures and then made u central and longitudinal incision along the digital extension tendon to expose the fracture.After reduction,we fixed the fracture with un AO titanium micro-plate and screws.Results 83 metacarpal and phalanx fractures of 76 cases were treated with AO titanium micro-plates and screws.There were 29 trans-articular fractures,The clinical healing time ranged 4-8weeks and averaged 5 weeks.100% of the cases were rated as good or excellent in the TAM scores,Conclusion The treatmeni of hand fractures with AO titanium micro-plates can offer solid fixation and anatomic reduction for various complicated fractures.The operation skill is not difficult,The function exercise could be launched from the day following the operation,which can prevent adhesion of palm and digit tendon.