微型外固定支架治疗掌指关节囊内粉碎性骨折

目的 评价应用微型外固定支架治疗掌指关节囊内粉碎性骨折的疗效.方法 8例掌指关节囊内粉碎性骨折,其中开放性损伤6例,闭合性损伤2例.采用Orthofix微型外固定支架固定,其中2例同时加用克氏针内固定,2例采用皮瓣覆盖创面.结果 术后平均8周骨折均愈合,未出现关节面不平整或关节间隙狭窄,受伤关节无不稳定.掌指关节活动范围达65°～85°,手握力达健侧80%～90%.结论 应用Orthofix微型外固定支架治疗掌指关节囊内粉碎性骨折,不仅能有效固定关节内的骨折,且大大缩短了骨折端的愈合时间,早期功能锻炼有效地减少了手指的致残率.

Treatment of intra-articular comminuted fractures of the metacarpophalangeal joint by mini external fixator

Objective To evaluate the clinical outcomes of treating intraa-articular comminuted fractures of the metacarpophalangeal joint by mini external fixator. Methods Eight cases of intra-articular comminuted fractures of the metacarpophalangeal joint were treated with Orthofix mini external fixator. Six were open injuries and 2 close injuries. Additional Kirschner wire fixation was done in 2 cases and flap transfer was carried out in 2 cases with severe soft tissue injury. Results All fractures were healed 8 weeks postoperatively. No rough articular surface and narrow joint space occurred. There was no joint instability. The average range of motion of the metacarpophalangeal joint was 65° to 85°. The average grip strength was 80% to 90% of that of the contralateral side. Conclusion Orthofix mini external fixator is an effective way for treatment of intra-articular comminuted fractures of the metacarpophalangeal joint. Not only can it decrease the fracture union time but also allow early postoperative functional rehabilitation which leads to reduced the rate of disability.