叶茂

[摘要] 目的 探讨微型锁定钢板内固定治疗多发掌骨粉碎性骨折的临床疗效。方法 随机选取2013年1—9月该院收治的多发掌骨粉碎性骨折患者80例，根据随机对照原则均分为两组，其中观察组40例患者采用微型锁定钢板内固定治疗，对照组40例患者采用单纯的微型螺钉钢丝捆扎治疗，观察患者的临床治疗效果以及术后3月的随访结果。 结果 治疗后观察组患者治疗34例患者术后恢复情况评定结果优（34例）、良（5例）、差（1例），明显由于对照组的优（28例）、良（8例）、差（4例），两组比较差异有统计学意义（P<0.05）。结论 微型锁定钢板内固定治疗多发掌骨粉碎性骨折，可以有效地达到临床上要求的解剖复位愈合，患者术后愈合较好，术后随访患肢功能恢复情况较好，具有较好的临床效果，可以在临床上进一步推广应用。

[关键词] 多发掌骨粉碎性骨折；微型锁定钢板；内固定；疗效分析

[中图分类号] R687.3 [文献标识码] A [文章编号] 1674-0742（2015）06（c）-0078-02

[Abstract] Objective To discuss the clinical effect of miniature locking plate internal fixation therapy in the treatment of multiple comminuted fractures of metacarpal bones. Methods 40 cases of patients with multiple comminuted fractures of metacarpal bones who were received and cured in our hospital were selected and all the patients were treated with the miniature locking plate internal fixation therapy. The clinical effects and follow-up results of the patients in 3 months after the operation were observed and analyzed. Results There are 36 cases of healing by first intention in the 40 cases of patients with operative incision healing rate 90.0% and without infection of incisional wound. The anatomical reduction was kept for all the patients after operation and bony union was achieved without malunion and delayed union. The healing time is 3-7 weeks， averaging（4.5±0.5）weeks. In the follow-up visit 3 months after the operation， the evaluation results of downward pointing functions of fracture metacarpal bone are as follows： excellent： 34； good： 5； bad： 1； the postoperative recovery rate was 85.0%. Conclusion The application of miniature locking plate internal fixation to multiple comminuted fractures of metacarpal bones can effectively achieve the anatomical reduction union required clinically， and the postoperative union of patients is quite good with a low occurrence rate of complications as malunion etc. The functional recovery of patients in the post-operation follow-up is quite good with good clinical effects， so it is worth being further promoted and popularized clinically.

[Key words] Multiple comminuted fractures of metacarpal bones； Miniature locking plate； Internal fixation； Analysis of curative effect

掌骨骨折是手外科临床上常见的创伤性疾病之一，占手外伤的25%左右，一般多见于青年人，目前临床上治疗掌骨骨折多采用钢板内固定、石膏外固定等方式治疗。但是对于病情复杂、多发性的掌骨粉碎性骨折，目前临床上手术入路以及内固定装置的选择，对于患者术后的功能恢复以及手术效果具有明显的影响，若手术方式不当以及内固定装置效果不好，容易产生关节僵硬、骨折畸形愈合或不愈合等并发症[1-2]。目前多发掌骨粉碎性骨折常用的治疗为微型锁定钢板内固定治疗，近年来该院采用微型锁定钢板内固定治疗多发掌骨粉碎性骨折取得了较好的临床效果，该研究将对2013年1月—2013年9月该院收治的80例多发掌骨粉碎性骨折患者的临床资料统计分析，现报道如下。……