Mallet骨折内固定方法的改进

目的：探讨Mallet骨折的治疗方法和临床疗效。方法2012年3月—12月，我们采用切开复位应用3枚克氏针内固定治疗Mallet骨折17例，采用Doyle分型，其中ⅣB型12例，ⅣC型5例。结果术后随访6～18个月，切口均一期愈合，17例骨折均愈合，愈合率100%，骨折愈合时间6～10周，平均9周，无并发症发生。采用 Dargan 法评估疗效，优14例，良2例，可1例，优良率94.12%。结论增加一枚加压克氏针内固定技术治疗Mallet 骨折，能稳定有效固定较小的骨折块，改善关节活动范围及降低术后关节疼痛，是治疗Mallet骨折的有效方法之一。

Novel surgical procedure for the mallet fractures

Objective The aim of this study was to present and evaluate a novel surgical procedure for the mallet fractures. Methods We have treated 17 patients with displaced mallet fractures by using the open reduction and Kirschner pin fixation between March 2012 and December 2012. According to Doyle classification, there were 12 cases of type ⅣB and 5 cases of type ⅣC fractures. Results The mean follow-up duration was 11 months （range 6 to 18 months）. Bone union was achieved in all patients within a mean period of 9 weeks （range 6 to 10 weeks）, with no incidence of infection, skin necrosis, nail deformity, fracture pieces of broken, refracture or secondary osteoarthritis. All patients were evaluated radiologically and clinically according to Crawford＆#39;s criteria. The surgical outcomes obtained were excellent in 14 cases, good in 2 cases, and fair in 1 case, and the good rate was 94.12%. Conclusion Our novel surgical procedure combining open reduction with extension block and flexion block using Kirschner wires fixation has good clinical results. The safe and effective method could be used in all mallet fractures.