PDLLA可吸收螺钉在断指再植中的应用

目的 分析PDLLA可吸收螺钉在断指再植骨折内固定治疗中的效果.方法 2005年10月-2007年10月,应用PDLLA可吸收螺钉作为髓内钉对9例断指再植进行治疗,其中4例为中节指骨处离断,5例为近节指骨处离断.术后3～4周拆除石膏进行保护性功能锻炼.结果 术后所有再植断指均存活,无骨折再移位或松动,术后6～8周骨折均达到骨性愈合.随访6～28个月,平均12.6个月.9例患指均无伤口肿胀、渗出或感染,断指功能恢复良好.结论 PDLLA可吸收螺钉能有效地固定断指骨折,并在术后3～4周进行功能锻炼,有利于患指功能的恢复.

The application of bioabsorbable Poly-DL-Lactic Acid (PDLLA) screws in digit replantation

Objective To evaluate the clinical results of using bioabsorbable PDLLA screws for bone fixation in digit replantation. Methods From October 2005 to October 2007, bioabsorbable PDLLA screw was used as an intramedullary pin to fix the fracture in 9 cases of digit replantation. The fingers were severed at the middle phalanx in 4 patients and at the proximal phalanx in 5 patients. Plaster was removed 3 to 4 weeks after the surgery and protected rehabilitation was initiated. Results All the replanted fingers survived. There was no fracture displacement or loosening of the screw. All fractures achieved bone healing at 6 to 8 weeks after the operation. The patients were followed up for 6 to 28 months, with an average of 12.6 months. No edema, exudation or infection of the wound was noted. Functional recovery of the replanted fingers was good. Conclusion Intramedullary fixation using bioabsorbable PDLLA screw is an effective method for fracture fixation in digit replantation. The technique allows early mobilization, which benefits the functional recovery of injured digits.