微型加压螺钉在不稳定掌、指骨骨折中的应用

目的 对不稳定掌、指骨骨折用微型加压螺钉切开复位内固定的方法及效果进行评价和分析。方法 闭合掌骨骨折以骨折断端为中心做掌背侧纵形切口；指骨做背外侧切口，开放骨折按照伤口情况另做切口或就原伤口入路，复位后在垂直骨折面打入2枚（或1枚）微型加压螺钉，术后不用石膏外固定，3天后即开始被动活动，10天后开始主动活动，6周内 禁用手持重。有肌腱损伤者及1枚螺钉固定者，术后石膏外固定3周开始功能锻炼。结果 骨折愈合时间平均8周，掌指及指间关节功能恢复满意；无畸形愈合、延迟愈合和骨不连。随访时间3个月－1年半，平均7个半月。2例发生创伤性关节炎，2例取钉困难。结论 微型加压螺钉是治疗不稳定掌、指骨骨折的比较好的内固定方式。

Unstable phalanges and metacarpal fractures treated by compression microscrew

Objective To analyse the effects of compression microscrew in treatment of 38 cases of unstable phalanges and metacarpal fracture.?Methods The metacarpals and phalanges were approached through longitudinal incision then curved distally to expose the metacarpo phalangeal joint as necessary. In open facture, the approach was modified according to the type of wound.2(or 1) microscrews were inserted.Active exercise began in 3 days postoperation and positive exercise in 10 days.If soft tissue damage was severe, the hand should be fixed for three weeks.?Results All patients have been followed up for three months to one and a half year.Wound healed and the average time for healing of fracture was 8 weeks. No severe complication happened.?Conclusion Conpression microscrew is a feasible method to treat the unstable fracture of hand.