经皮闭合穿针治疗新鲜掌板撕脱骨折

目的 总结利用经皮闭合穿针治疗新鲜掌板撕脱骨折的经验,为临床治疗掌板撕脱骨折提供可靠、有效的治疗方法.方法 2002-2007年,对6例掌板撕脱骨折的患者,在局部麻醉下经皮闭合穿针内固定方法进行治疗.6例均为近侧指间关节中节指骨基底撕脱骨折.受伤至手术的时间为1～8d,平均3.5d.结果 术后随访时间为3个月至5年3个月,平均1年5个月.6例患者均于术后6～8周(平均6.8周)达到骨折愈合.患指经功能锻炼后,术后均无静息痛,近侧指间关节屈曲为78°～100°(平均83.5°),伸直0°～-10°(平均-6.5°).结论 经皮(屈曲阻挡,Flexion blocking)闭合穿针内固定是一种治疗手指近侧指间关节掌板撕脱骨折可靠、有效的方法.

Treatment of acute volar plate avulsion fracture by percutaneous pin fixation

Objective To summarize the experience of treating acute volar plate avulsion fracture by percutaneous pin fixation, investigate its feasibility and effectiveness. and provide a reliable and effective treatment method for acute volar plate avulsion fractures. Methods From 2002 to 2007, 6 patients with acute volar plate avulsion fractures were treated surgically by percutaneous pin fixation under regional anesthesia. There were 4 men and 2 women with an average age of 26 years. Among them, 2 index fingers, 2 long fingers, 1 ring finger and 1 little finger were involved. The cause of the injury was sports injury in 4 cases, accident in 1 case, and forceful twisting in 1 case. Duration from injury to operation ranged from 1 to 8 days with an average of 3.5 days. Follow-up period ranged from 3 months to 5 years and 3 months, with an average of 1 year and 5 months. All 6 cases sustained avulsion fractures of middle phalanx base at the proximal interphalangeal (PIP) joint. Results All the patients achieved bone union at mean 6.8 weeks (range, 6 to 8 weeks) postoperatively. After rehabilitation PIP joint flexion reached 78° to 100° (average 83.5°) while PIP joint extension was 0° to -10°(average -6.5°). No static pain was found among those patients and they were all satisfied with their treatment outcome. Conclusion Percutaneous flexion blocking pin fixation was a reliable and effective treatment method for acute volar plate avulsion fractures.