微型单侧外固定支架治疗第一掌骨基底骨折

目的 总结微型单侧外固定支架治疗第一掌骨基底骨折的手术方法及其疗效经验。方法 将86例第一掌骨底基骨折患者拇指向桡远侧持续牵引，在骨折线远近端（第一掌骨远端及大多角骨和舟状骨）旋入4枚螺杆，在X线透上手法复位，通过调节侧方延长杆纠正短缩及分离，用万向球形关节纠正成角或旋转畸形。术后2h-2d即能活动拇指间关节，进行主动伸屈功能操练。 固定4－6周拆除支架锻炼活动。结果 86例患者随访80例，失访6例。去支架后随访半年至3年9个月，平均26个月。90％患者拇指外展、内收、内旋及对掌功能恢复良好。结论 微型单侧外固定支架结构简单，使用方便，固定可靠，临床效果满意。

Evaluation of the efficacy of miniunilateral fixater for treatment of basal metacarpal fractures of thumb

Objective To summerize the operation methods of basal metacarpal fractures of thumb by miniunilateral fixator and evaluation of it effectiveness. Method Confirmed by the image intensifier, the fracture was reduced by longitudinal radial traction, the two proximal pins were placed in the trapezium and scaphoid, the distal two pins in the first metacarpal distal to the fracture. Shortening and lengthening malalignment can be corrected through the adjustment of lateral distractor rod, versatile ball joint can reduce rotational and angulatory deformity. Interphalangeal joint mobilization exercise began 2h-2d postoperatively to exercise. The fixator was removed 4-6weeks afterwards. Results 80 cases were followed up observed for 6 months-3.75years, averagely 26months. 90 % patient had good recovery of mobilization. Conclusion The fixator is simple, convenient and reliable which gives rise to satisfactory results. (Shanghai Med J, 2001,24:163)