应用钩钢板内固定技术治疗mallet骨折

目的 介绍应用钩钢板内固定技术治疗mallet骨折的手术方法 及疗效.方法 2006年8月-2008年2月,应用钩钢板内固定技术治疗25例mallet骨折患者,其中Ⅰ B型18例,ⅡB型7例.采用2.0 mm Medicon微型直钢板制备1孔钩钢板,切开复位内固定骨折,术后行限制性远指间关节早期功能锻炼.结果 所有患者术后获2～18个月(平均10个月)随访,骨折均顺利愈合,愈合时间平均5周.术后疼痛程度和关节屈伸活动度评价:优14例,良9例,可2例,差0例;优良率为92%.术后未发生严重并发症.结论 应用钩钢板切开复位内固定技术治疗mllet骨折,复位牢固可靠,内固定物不固定骨折块和关节,允许早期关节活动,有效降低术后关节疼痛和关节活动受限,是治疗撕脱骨折块大于末节指骨基底关节面1/3 mallet骨折的有效方法 .

Treatment of Mallet fractures with internal fixation using hook plate technique

Objective To introduce the surgical techniques and clinical outcomes of trestment of Mallet fractures using hook plate internal fixation. Methods From August 2006 to February 2008, 25 cases of Mallet fractures were treated with hook plate internal fixation. There were 18 cases of Ⅰ B type fractures and 7 cases of Ⅱ B type fractures. Open reduction and internal fixation was performed using a one-hole hook plate fabricated from a 2.0 mm Medicon straight plate. Early postoperative protected motion of the distal interphalangeal (DIP) joint was allowed. Results All the cases were followed up for 2 to 18 months, with an average of 10 months. All the fractures healed successfully, with an average bone union time of 5 weeks. Functional evaluation included degree of pain and DIP joint flexion and extension. The results were rated as excellent in 14 cases, good in 9 cases, fair in 2 cases and poor in 0 case. The overall good-excellent rate was 92%. There were no postoperative complications. Conclusion Treatment of Mallet fractures with hook plate internal fixation technique can achieve more tellable fixation than conventional methods. This technique avoids placing implants or wires through the small avulsion fragment and the DIP joint while still being able to achieve a stable fixation construct strong enough to allow protected early active motion of the DIP joint. In minimizing the need for prolonged sprinting, patient comfort is also improved . It is an effective method for treatment of Mallet fractures involving more than one-third of the base of the distal phalanx.