拇指外展牵引固定器治疗第1掌骨基底部骨折临床观察及生物力学研究

为观察拇指外展牵引固定器的临床效果及生物力学性能。自行研制拇指外展牵引固定器 ,在固定第 1掌骨的同时 ,行拇指近节皮肤牵引。以石膏托外固定及克氏针交叉固定为对照 ,进行生物力学比较研究。结果治疗 18例 ,治愈 13例 ,好转 5例。该方法能为骨折固定提供良好的力学保证 ,固定器的强度裕度为 42 ,其应变、强度和刚度与交叉克氏针内固定和石膏托固定分别相差 3.7%和 6 .2 4%;1%和 2 %;6 .3%和 6 .8%;显示与克氏针内固定无显著性差异 (P >0 .0 0 1) ,但优于石膏固定。认为该方法能满足治疗第 1掌骨基底部骨折的各项生物力学性能 ,安全可靠 ,是一种有效的非手术疗法。

THE TREATMENT OF THE FIRST METACARPAL BASE FRACTURE BY THUMB ABDUCTION TRACTOR-FIXER AND ITS BIOMECHANICAL STUDY

The aim of the paper is to observe the clinical therapeutic effect and biomechanical properties of thumb-abduction tractor-fixer. Eighteen cases of the first metacarpal base fracture were treated by self-developed thumb-abduction tractor-fixer and proximal thumb skin traction, and a biomechanical and comparative study was made using external plaster-support fixation and crossed Kirschner-pins fixation as the control. The results included 13 cases cured and 5 cases improved. This method could offer a good mechanical guarantee for the fracture immobilization; the fixer showed no significant difference (P > 0.01) from Kirschner-pins fixation but had an advantage over plaster-support fixation as its strain, strength (42) and rigidity were only 3.7% and 6.24%, 1% and 2%, and 6.3% and 6.6% less than those of Kirschner-pins fixation and plaster-support fixation, respectively. This method was regarded as a safe, reliable and effective non-operative therapy for the first metacarpal base fracture because it could meet all the biomechanical demands of the treatment of the fracture.