微型钢板螺钉内固定治疗手部骨折临床疗效观察.docVIP

微型钢板螺钉内固定治疗手部骨折临床疗效观察 　　【摘要】目的分析探究微型钢板螺钉内固定治疗手部骨折的临床疗效及安全性。方法对我院2010年3月至2011年3月收治的51例手部骨折患者采用微型钢板螺钉内固定治疗，观察其临床效果。结果所有患者伤口均一期愈合，随访3~12个月，骨折愈合时间1.5~3个月，无骨不连、畸形愈合。手部功能恢复(TMP系统评定)情况：优39例(76.47％)，良9例(17.65％)，可3例(5.88％)，优良率94.12％。结论应用微型钢板螺钉内固定治疗手部骨折，固定确切可靠，损伤小，术后可早期功能锻炼，是手部骨折首选治疗方法，值得临床推广应用。 　　【关键词】钢板；螺丝钉；内固定；手部骨折；临床疗效 　　 　　Treatment analysis of internal fixation on hand fractures with miniplate and screwZHAI Xi.Depatment of Hand Surgery,Affiliated Fengtian Hospital of Shenyang Medical College,Shenyang 110024,China 　　【Abstract】ObjectiveTo study the treatment effect and safety of miniplate and screw on hand fractures. MethodsA retrospective analysis of clinical data was conducted in 51 patients with hand fractures who were admitted in our hospital from march 2010 to march 2011.All the patients were treatment with miniplate and screw and the clinical effect were observed. ResultsThe whole patients were primary healing, all cases were followed up 3 months to 12 months,the time of union of fracture were 1.5 months to 3 months, no complications occurred of displacement and malunion of fractures. Evaluated by the TAM system, the excellent rate was76.47％, the fine rate was 17.65％, the general rate was 5.88％ and the healing excellent rate was 94.12%. ConclusionMiniplate and screw have reliable and valid fixation and get less complications for hand fractures. Active motion of joints could be begun earlier postoperatively. Study showed that miniplate and screw were effective methods and should be chosen firstly. 　　【Key words】Nickelclad；Screw；Internal fixation；Hand fractures；Clinical effect 　　 　　作者单位：110024沈阳医学院附属奉天医院手外二科随着社会的发展，手外伤越来越得到临床医生的重视。对于手部骨折的治疗，早期确切复位内固定与患者手部功能的恢复关系密切。伴随着骨科器械的成熟应用，采用微型钢板螺钉已经代替了以往的多种外固定和内固定方法，并取得满???效果［1，2］。本文回顾我科采用微型钢板螺丝钉内固定治疗手部骨折患者的情况，现报告如下。 　　1资料与方法 　　1.1一般资料本组患者51例74处骨折，男39 例，女12 例，年龄18~46 岁，平均27.9 岁；致伤原因：机器压伤14例，重物砸伤6 例，摔伤8 例，车祸伤17例，刀砍伤3 例，其他3 例；骨折部位：指骨骨折32 例，掌骨骨折29 例，腕骨骨折13例。骨折类型：闭合性骨折33 例，开放性骨折41 例。 　　1.2治疗方法所有患者均采用臂丛神经阻滞麻醉，在止血带控制下操作，掌骨骨折