微型钢板螺钉在掌指骨骨折治疗中的应用研究

目的：为提高微钢板螺钉治疗掌、指骨骨折效果,作者总结了1998-2000年用微型钢板螺钉治疗28例掌、指骨骨折。方法：共19人,28例骨折。男11人,女8人;掌骨17例;指骨11例;单纯骨折7例,有合并伤12例;闭合性骨折9例,开放性骨折19例。骨干部骨折用4孔微型钢板固定,干骺骨折用“T”或“L”形微型钢板固定;大斜形或螺旋形、关节内骨的用螺钉加压固定。术后即行主、被动活动,随访2周-11个月。结果：术后18例关节活动达到优秀,其中：掌骨骨折14例（14/17）,指骨骨折4例（4/11）;开放性骨折6例（6/19）,闭合性骨折8例（8/11）。9例发生了并发症,其中：掌骨2例（2/17）,指骨7例（7/11）;开放性骨折7例（7/19）,闭合性骨折2例（2/11）。结论：微型钢板及螺钉为掌、指骨骨折提供了牢稳的固定,有利于早期功能康复训练,获得了较好的手功能恢复;掌骨骨折优于指骨骨折,闭合性骨折优于开放性骨折。

The Use of Miniplate and Screw in Metacarpal and Phalangeal Fractures

Objective: In order to improve the treatment effect of miniplate and screw on metacarpal and phalangeal fractures,the authors reviewed 28 fractures in 19 patients who were treated with miniplate and screw from 1998 to 2000.Method:There were 11 males and 8 females.Twenty eight fractures were of 17 metacarpla and 11 phalangeal fractures,19 open and 9 closed fractures,7 only fractures and 21 fractures with other injuries.The 4 hole 2.0mm miniplate used for midshaft fractures of the phalanges and metacarpals;the "T"or"L"-shaped plate used for unstable intraarticular and periarticular fractures;the screw used for long oblique diaphyseal fractures,spiral fractures and some of intraarticular fractures.Immediate active and passive motion postoperatively.Results:The quality of recovery of joint motion was assessed using the Total Active Flexion Scale,18(18/28) cases were graded excellent,including 14(14/17) metacarpal and 4(4/11) phalangeal fractures,6(6/19) open and 8(8/9) closed fractures.Complications occurred in 9 of 28 fractures,including 2(2/17) metacarpal and 7(7/11) phalangeal fractures,7(7/19) open and 2(2/9) closed fractures.Conclusion:Miniplates and screws provide the stable fixation to metacarpal and phalangeal fractures,and stabilize the fracture site allowing immediate motion postoperatively,so that the hand function recovers better and more quick.Metacarpal fractures had a significantly higher percentage of excellent results than did phatangeal fractures,closed fractures more than open fractures.