手部自制克氏针—橡皮筋可活动型外固定牵引架治疗近节指间关节骨折脱位的疗效评价(1)
【摘要】 目的：觀察并评价手部自制克氏针-橡皮筋可活动型外固定牵引架在近节指间关节骨折脱位中的治疗作用。方法：选择2015年1月-2016年1月在本院治疗的近节指间关节骨折脱位患者60例，均采用手部自制克氏针-橡皮筋可活动型外固定牵引架治疗。比较所有患者手术前后Michigan手功能问卷表(MHQ)评分、患侧握力占健侧比及关节活动度的差异，并进行术后随访，观察所有患者的骨折愈合情况、并发症情况及手部运动功能恢复情况。结果：对60例患者进行平均(16.84±5.25)个月的随访，术后平均(6.43±1.38)周所有患者均拆除了外固定支架，并经X线复查显示，所有骨折均呈骨性愈合，指间关节无侧偏及分离，平均愈合时间为(12.47±3.21)周，且复位满意，未见骨性不愈合及针道感染等并发症发生。术后TAM疗效，其中优31例，良18例，可8例，差3例，优良率为81.67%。术后，患者的平均MHQ评分、患侧握力占健侧比及关节活动度均明显优于术前，差异均有统计学意义(P<0.05)。结论：手部自制克氏针-橡皮筋可活动型外固定牵引架治疗近节指间关节骨折脱位效果较理想，有助于骨折固定及术后手指早期功能康复，故提倡使用推广。
, 百拇医药
【关键词】 近节指间关节； 骨折脱位； 外固定牵引架
【Abstract】 Objective：To observe and evaluate the effect of self-made Kirschner’s needle and rubber band movable external distraction fixator in the treatment of fracture dislocation of proximal interphalangeal joint.Method：A total of 60 cases with fracture dislocation of proximal interphalangeal joint in our hospital from January 2015 to January 2016 were given the self-made Kirschner’s needle and rubber band movable external distraction fixator.MHQ score，ratio of the affected side to the healthy side and the difference of joint activity of all patients before and after surgery were compared，and were followed up after operation，and the fracture healing， complications and hand motor function recovery of all patients were observed.Result：All patients were followed up for an average of(16.84±5.25)months，and were dismantled the external fixation stents after operation for average of(6.43±1.38)weeks and were examined by X-ray examination.All fractures showed bony union，and there was no lateral deviation and separation of the interphalangeal joints，and the average healing time was (12.47±3.21)weeks，and all the fractures were satisfactory.There was no bone nonunion and pin tract infection occurred.The clinical effect of TAM after operation，which 31 cases were excellent，18 cases were good，8 cases were good，and 3 cases were poor，and the good rate was 81.67%.After the operation，the average MHQ score，the side grip strength of the affected side and the joint activity were significantly better than those of before operation，the differences were statistically significant(P<0.05).Conclusion：The effect of self-made Kirschner’s needle and rubber band movable external distraction fixator in the treatment of fracture dislocation of proximal interphalangeal joint are ideal，which it is helpful to the fixation of fracture and the rehabilitation of the early function of the fingers.Therefore，it is worthy to be used and promoted., 百拇医药(詹金昌 林跃 吴太东 宁思 邵朝阳)
, 百拇医药
【关键词】 近节指间关节； 骨折脱位； 外固定牵引架
【Abstract】 Objective：To observe and evaluate the effect of self-made Kirschner’s needle and rubber band movable external distraction fixator in the treatment of fracture dislocation of proximal interphalangeal joint.Method：A total of 60 cases with fracture dislocation of proximal interphalangeal joint in our hospital from January 2015 to January 2016 were given the self-made Kirschner’s needle and rubber band movable external distraction fixator.MHQ score，ratio of the affected side to the healthy side and the difference of joint activity of all patients before and after surgery were compared，and were followed up after operation，and the fracture healing， complications and hand motor function recovery of all patients were observed.Result：All patients were followed up for an average of(16.84±5.25)months，and were dismantled the external fixation stents after operation for average of(6.43±1.38)weeks and were examined by X-ray examination.All fractures showed bony union，and there was no lateral deviation and separation of the interphalangeal joints，and the average healing time was (12.47±3.21)weeks，and all the fractures were satisfactory.There was no bone nonunion and pin tract infection occurred.The clinical effect of TAM after operation，which 31 cases were excellent，18 cases were good，8 cases were good，and 3 cases were poor，and the good rate was 81.67%.After the operation，the average MHQ score，the side grip strength of the affected side and the joint activity were significantly better than those of before operation，the differences were statistically significant(P<0.05).Conclusion：The effect of self-made Kirschner’s needle and rubber band movable external distraction fixator in the treatment of fracture dislocation of proximal interphalangeal joint are ideal，which it is helpful to the fixation of fracture and the rehabilitation of the early function of the fingers.Therefore，it is worthy to be used and promoted., 百拇医药(詹金昌 林跃 吴太东 宁思 邵朝阳)
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