骑缝钉固定治疗钩掌关节损伤

目的：探讨应用骑缝钉固定治疗钩掌关节损伤的疗效。方法： 2009年5月至2012年11月应用骑缝钉固定治疗钩掌关节损伤16例，其中男10例，女6例；年龄21～57岁，平均33.6岁。单纯第4和（或）第5掌骨基底脱位11例；第4和（或）第5掌骨基底脱位伴钩骨背侧撕脱性骨折5例。定期复查X线片了解骨折愈合、关节复位及骑缝钉位置情况，采用手指关节总活动度（TAM）系统评定法评价腕掌关节及掌指关节功能。结果：所有患者切口均I期愈合，未发生感染。所有病例均获随访，时间6～24个月，平均（10.0±2.7）个月，无再发脱位，内固定位置良好，无退钉、断钉。5例伴有钩骨背侧撕脱性骨折的患者获得良好骨性愈合。腕掌关节及掌指关节功能：优10例，良5例，中1例。结论：骑缝钉固定治疗钩掌关节损伤具有操作简单，创伤小，固定可靠，术后早期功能锻炼等优点，是治疗钩掌关节损伤的理想手术方式。

Staple fixation for the treatment of hamate metacarpal joint injury

Objective: To investigate the effcacy of the staple fixation for the treatment of hamate metacarpal joint injury. Methods: From May 2009 to November 2012,16 patients with hamate metacarpal joint injury were treated with staple fixation including 10 males and 6 females with an average age of 33.6 years old ranging from 21 to 57 years. Among them,11 cases were on the fourth or fifth metacarpal base dislocation without fractures,5 cases were the fourth or fifth metacarpal base dislocation with avulsion fractures of the back of hamatum. Regular X-ray review was used to observe the fracture healing,joint replacement and position of staple fixation. The function of carpometacarpal joint and metacarpophalangeal joint were evaluated according to ASIA(TAM) system evaluation method. Results: All incision were healed well with no infection. All patients were followed up from 16 to 24 months with an average of(10.0±2.7) months. No dislocation recurred,the position of internal fixator was good,no broken nail and screw withdrawal were occurred. Five patients with avulsion fracture of the back of hamatum achieved bone healing. The function of carpometacarpal joint and metacarpophalangeal was excellent in 10 cases,good in 5 cases,moderate in 1 case. Conclusion: The application of the staple for the treatment of hamatometacarpal joint injury has the advantages of simple operation,small trauma,reliable fixation,early postoperative function exercise and other advantages,which is the ideal operation mode for hamatometacarpal joint injury.