三角钢丝固定法在近指间关节周围断指再植中的应用

目的 评价在近指间关节周围断指再植时采用三角钢丝内固定法的临床疗效.方法　13例(19指)近指间关节周围的断指,其中中节基底13指,近节远端6指,断指再植时采用三角钢丝内固定法重建骨支架.结果　术后平均7周达骨愈合,近指间关节活动范围5°～84°.参照中华医学会手外科学会上肢部分功能试用标准进行评定,本组中优15指,良3指,差1指,优良率为94.7％.结论　在近指间关节周围断指再植时,采用三角钢丝法进行内固定,操作简便,有效固定的同时可允许早期开展关节功能训练,恢复良好的关节功能,临床效果满意.

Application of Triangle-Wire Fixation in Digital Replantation Around the Proximal Interphalangeal Joint

Objective To evaluate the clinical outcome of triangle-wire fixation in digital replantation around the proximal interphalangeal joint. Methods Nineteen fingers （13 cases） amputated around the proximal interphalangeal joint were fixed with triangle-wire fixation. Among them, 13 were amputated at the base of middle phalange and 6 at distal end of proximal phalange. Results The mean bone healing time was 7 weeks. The average range-of-motion of the proximal interphalangeal joint was 5°-84°. According to the tentative standard raised by Hand Surgery Society of Chinese Medical Association for functional evaluation of upper limb, the function was rated as excellent in 15 fingers, good in 3 fingers and poor in 1 finger. The choiceness rate was 94.7%. Conclusion Triangle-wire fixation in digital replantation is an effective way for the fingers amputated around the proximal interphalangeal joint. It can not only fix the fracture stably, but also allow early postoperative functional exercise leading to perfect function of the joint and satisfactory clinical results.