弹性牵引外架结合部分钩骨关节面移植治疗陈旧性指间关节损伤

目的 探讨弹性牵引外架结合部分钩骨腕掌关节面移植在手指指间关节结构性骨缺损功能重建中的价值.方法 回顾性分析2016年11月-2019年1月解放军总医院第七医学中心骨科学部收治陈旧性指间关节部分结构性缺损患者17例(17指),男性15例15指,女性2例2指;年龄20～ 55岁,平均32.2岁.重物挤压伤6例6指,电锯切...

Elastic traction external frame combined with hemi-hamate autograft for the reconstruction of interphalangeal bone defects

Objective To investigate the value of elastic traction external frame combined with hemi-hamate autograft for the reconstruction of interphalangeal bone defects.Methods Totally 17 patients with 17 fingers treated in The Department of Orthopedics of PLA General Hospital from Nov.2016 to Jan.2019 was selected,including 15 males and 2 females whose age ranged from 20 to 55 years,with an average of 32.2 years.Six cases were injured by heavy weight crushing,10 cases were injured by electric saw,and 1 case was injured by hammer.All the patients were selected because of partial structural defect of interphalangeal joint,and repaired by transfer of hamate articular surface.Mini-screw and elastic traction frame were used to fix the repaired part.The patients were guided to take active functional exercise 1 week after operation,and the external fixation was removed 6 weeks after operation to gradually strengthen joint functional exercise.The patients were followed up at least 10 months for recovery.Results The patients were followed up for 10 to 30 months,with an average of 12.0 months.All the patients'finger joint bone defect and structural bone graft healed in the first stage,and there was no obvious joint deformity.The patients were satisfied with the joint movement,and the total motion range of the finger was 190.0°-260.0°,with an average of 210.0°.Based on the total active motion(TAM)evaluation,the results was rated as excellent in 11 fingers,good in 4 fingers,fair in 2 fingers.The rate of excellent and good was 88.23%.Conclusion Elastic traction external frame combined with hemi-hamate autograft is effective in the treatment of old interphalangeal joint injury,which is conducive to the improvement of patients'joint activity,and is worthy of further clinical application.