术后尺偏手畸形17例临床分析

目的 分析手外伤术后并发尺偏手畸形的原因及治疗措施.方法 回顾性分析17例手外伤术后并发尺偏手畸形患者的临床资料.结果 17例患者中掌骨成角畸形者联合予截骨矫形微型钢板内固定术4例、腕掌关节失稳联合行融合内固定术8例,掌骨不稳予植骨融合克氏针固定5例;所有患者均康复出院,住院时间15 ～24 d,平均(17.6±2.1)d.并发尺偏手畸形的主要原因:患者手掌指关节的指背腱膜与伸肌腱向尺侧拉力增大,并与手掌内侧肌肉产生对抗;掌骨多发骨折致畸形愈合或腕掌关节失稳;掌深横韧带损伤致掌骨相对不稳等.尺偏手畸形发生在手术后2～7个月,平均(4.1±1.1)个月;食指、中指、环指及小指与拇指等治疗前后偏角差异均有统计学意义(t=9.3213、9.8826、9.3605、9.4561,均P＜0.05).随访1～3年,尺偏手畸形均得到有效纠正.结论 手掌压砸伤术后并发尺偏手畸形有多种原因,需要采取手术治疗.

Clinical analysis of 17 patients with postoperative ulnar deviation hand deformity etiology

Objective To analyze the causes and treatment measures of postoperative ulnar deviation hand deformity etiology. Methods Clinical data of 17 cases of hand injuries postoperative ulnar deviation hand deformities were retrospectively analyzed. Results 17 patients with metacarpalI osteotomy miniplate fixation of four cases of an- gular deformity jointly carpometacarpal joint instability of joint fusion and internal fixation of eigLt cases, the metacar- pal instability for interbody fusion of five cases of Kirschner wire; all patients were discharged, length of stay from 15 to 24d, the average （17.6 ± 2.1 ）d. Concurrent ulnar deviation a hand deformity of the main reasons：patients with the palm of your hand refers to the joint dorsal aponeurosis and the extensor tendon to the ulnar tension increases, and the inside with the palm of your hand muscles to antagonize;the metacarpal multiple fractures caused by malunion or carpal joint instability;deep palmar transverse ligament metacarpal caused by the relative instability. Concurrent ulnar deviation hand deformity in 2 to 7 months after surgery, the average （4.1 ± 1.1 ） months;index finger, middle finger, ring finger and little finger and thumb before and after treatment, the declination differences were statistically signifi- cant（ t = 9. 3213,9. 8826,9. 3605,9. 4561, all P 〈 0.05 ）. Follow-up for 1 to 3 years, ulnar deviation hand deformities have been effectively corrected. Conclusion The palm of your hand after crush injury complicated by ulnar deviation hand deformity have a variety of reasons, need to take surgery.