AO微型钢板在指骨骨折中的应用

目的 探讨AO微型钢板内固定治疗指骨骨折的疗效。方法 2003年1月-2005年1月，对74例77指指骨骨折，采用AO微型钢板进行内固定治疗。术后第2天开始作主动功能锻炼。结果 术后随访8个月～2年，平均15个月。术后70指伤口I期愈合，7指伤口发生裂开或部分皮肤坏死，其中5指钢板外露，而行皮瓣修复。术后70例72指获得随访，4例失访。骨折愈合时间为10～15周，平均12周，均全部愈合。按手功能评定标准评定：优56指（77．8％），良6指（8．3％），可2指（2．8％），差8指（11．1％），总优良率为86．1％。结论 AO微型钢板在治疗指骨骨折中疗效显著，但钢板强度不足，其潜在断裂的可能性是其最大的缺点。

The application of AO miniature-plates and screws in treatment of phalangeal fractures

Objective To introduce the methods and results of the operative treatment of phalangeal fractures with AO miniature-plates and screws fixation.Methods From January 2003 to January 2005,74 cases of 77 phalangeal fractures were treated with open reduction and internal fixation with mini-plate.There were 56 males with ages between 19 to 58 years (average 37 years) and 18 females with ages between 21 to 46 years(average 29 years). Postoperative exercise of the involved digits started the second day following the surgery.Results Postoperative follow-up ranged from 8 months to 2 years,with an average of 15 months.Primary wound healing was achieved in 70 digits,while wound dehiscence and skin necrosis was observed in 7 digits.5 of these cases had exposure of the plate and were treated by flap coverage.72 fractures of 70 cases were followed to sufficient evaluation while 4 cases were lost to follow-up.The mean time of bone union was 12 weeks,ranging from 10 to 15 weeks.There was no delayed union, nonunion,malunion or loosening of fixation.Postoperative hand function was graded as excellent in 56 digits (77.8%),good in 6 digits (8.3%),fair in 2 digits (2.8%),and poor in 8 digits (11.1%).The overall satisfactory rate was 86.1%.Conclusion Open reduction and internal fixation with AO mini-plates is a satisfactory and effective technique in the treatment of phalangeal fractures.The drawback of this technique is the risk of plate breakage due to the limitation of plate mechanical strength.