west china medical publishers
Keyword
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Keyword "指骨" 16 results
  • A COMPARATIVE STUDY ON TWO DIFFERENT ABSORBABLE INTRAMEDULLARY NAILS IN TREATING METACARPAL AND PHALANX FRACTURES

    Objective To study the effect of two different absorbable intramedullary nails in treatment of metacarpal and phalanx fractures.Methods From January 2002 to December 2002, open reduction and internal fixation were done with two different absorbable intramedullary nails in 60 cases of metacarpal and phalanx fractures( 52 cases of open fractures and 8 cases of closed fractures). The fracture locations were metacarpal in 24 cases, proximal phalanx in 22 casesand media phalanx in 14 cases. The emergency operation was performed in 47 cases, selective operation in 13 cases.Out of 60 patients, 24 were treated with intramedullary nails of poly-DL-lactic acid (PDLLA) (PDLLA group), 36 with intramedullary wire of PDLLA composed of chitosan(PDLLA+chitosan group). Results In the PDLLA group(n=24), the rejection occurred in 8 cases 3-4 weeks after operation. PDLLA nails were taken out in 6 of the 8 cases after 5-10 days of operation and bone healing was achieved 2 months after re-fixation by Kirschner wire; therejection subsided in the other 2 cases after 25 days of conservative treatment, and bone fracture healed after 14 weeks. No rejection was observed with primary healing in the other 16 cases of the PDLLA group. In PDLLA + chitosan group(n=36), the rejection occurred in 1 case 19 days after operation, but therejection subsided after 3 days of conservative treatment.No rejection was observed in the other 35 cases with primary healing. All patients were followed up 4-11 monthswith an average of 6 months. No rejection was observed and bone healing was achieved during the follow-up. The time of bone healing was 6-16 weeks(8 weeks onaverage). There was statistically significant difference in the curative resultbetween two groups(Plt;0.05). Conclusion Intramedullary nail of PDLLAwas verysuitable to fix fractures of metacarpal and phalanx. During the degradation of PDLLA, the acidic products can cause rejection. When PDLLA mixed with chitosan,PDLLA can not only strengthen the intensity but also neutralize the acidity. So the rejection can be decreased.PDLLA intramedullary nails composed of chitosan were better than PDLLA intramedullary nails in clinical treatment of metacarpal and phalanx fractures.

    Release date:2016-09-01 09:33 Export PDF Favorites Scan
  • 微型钢板治疗掌指骨骨折的疗效分析

    目的 回顾性分析微型钢板治疗掌、指骨骨折的效果,评价其临床应用价值。 方法 2003 年1 月-2007 年6 月,采用微型钢板治疗掌、指骨骨折134 例174 处。男101 例,女33 例;年龄15 ~ 48 岁,平均27.8 岁。掌骨骨折105 处,指骨骨折69 处。闭合性骨折71 处,开放性骨折103 处。其中粉碎性骨折68 处,斜形或螺旋形骨折46 处,横形骨折32 处,粉碎性骨折合并骨质缺损13 处,病理性骨折(内生软骨瘤)合并骨质缺损15 处。合并伸屈肌腱损伤或神经损伤18 处,皮肤缺损11 处,累及关节的骨折16 处。伤后至手术时间2 ~ 72 h,平均6 h。 结果 术后伤口除1 例感染外,均Ⅰ期愈合。皮瓣供区Ⅰ期愈合。患者均获随访,随访时间6 ~ 12 个月,平均8.2 个月。X 线片示骨折线于术后6 ~ 11周消失。伤指外观无明显成角及旋转畸形。术后因疼痛不愿活动致关节僵硬3 指,累及关节的骨折致创伤性关节炎1 指,延迟愈合2 指,伤口感染1 指。无骨不连及畸形愈合。按照TAM 系统评定法,优115 处,良39 处,可12 处,差8 处,优良率88.5%。 结论 微型钢板治疗掌指骨骨折是一种有效的内固定方法

    Release date:2016-09-01 09:05 Export PDF Favorites Scan
  • 指骨骨样骨瘤二例报告

    详见正文

    Release date:2016-08-31 04:24 Export PDF Favorites Scan
  • FORWARD HOMODIGITAL ULNARIS ARTERY FLAP COVERAGE FOR BONE AND NAIL BED GRAFT IN THUMB FINGERTIP AMPUTATION

    Objective To approach a new procedure of microsurgery to repair thumb fingertip amputation with forward homodigital ulnaris artery flap coverage for bone and nail bed graft. Methods From March 2005 to October 2007, 6 cases of amputated thumb fingertip (6 fingers) were treated, including 4 males and 2 females and aging 23-63 years. Six patients’ (3 crush injuries, 2 cut injuries and 1 other injury) amputated level was at nail root (2 cases), mid-nail (3 cases), and the distalone third of nai bed (1 case). The time from injury to surgery was 3-10 hours, they were treated with forward homodigital ulnaris artery flap coverage for bone and nail bed graft. The flaps size ranged from 1.5 cm × 1.4 cm to 2.0 cm × 1.4 cm. Results All flaps survived. Wound healed in one-stage in 5 cases, and healed in second stage in 1 case because of swell ing. All skin grafting at donor site survived in one-stage. All patients were followed up for 6-8 months. The appearance of flaps were good, and the two-point discrimination was 5-6 mm. Bone graft were healed, the heal ing time was 4-5 weeks. All finger nails were smooth and flat without pain. Conclusion When there was no indication of replantation in thumb fingertip amputation, establ ishing the functional and esthetic construction can be retained with forward homodigital ulnaris artery flap coverage for bone and nail bed graf

    Release date:2016-09-01 09:06 Export PDF Favorites Scan
  • Application of double osteotomy and lengthening of proximal phalanx and metacarpal with Ilizarov technique for thumb defect

    ObjectiveTo investigate the effectiveness of double osteotomy and lengthening of proximal phalanx and metacarpal with Ilizarov technique in treatment of thumb defect. MethodsBetween February 2017 and June 2019, 6 patients with traumatic thumb defects were treated with double osteotomy and lengthening of proximal phalanx and metacarpal by Ilizarov technique. There were 5 males and 1 female. The age ranged from 28 to 57 years, with an average of 41.5 years. There were 3 cases on the left side and 3 cases on the right side. All patients were admitted to the hospital in emergency department after injury, and the stump of the thumb was trimmed and sutured. The osteotomy plane was the distal part of the proximal phalanx in 4 cases and the interphalangeal joint in 2 cases. The interval between injury and osteotomy was 20-245 days (median, 34.5 days). After minimally invasive osteotomy and placement of a semi-circular external fixator, the lengthening began on the 5th day. The proximal phalanx and metacarpal were lengthened by 0.5 mm every day, once every 12 hours. The thumb of the affected side was distracted to the middle of the distal phalanx of the healthy thumb, and the fixator was removed after the bone healed. ResultsThe distraction time was 14-23 days, with an average of 18.8 days. The osteotomies were healed with healing time of 91-147 days (mean, 120.2 days). The total distraction length of the proximal phalanx and metacarpal was 1.40-2.25 cm, with an average of 1.86 cm; healing index was 51.0-72.2 days/cm, with an average of 64.9 days/cm. All patients were followed up 5-12 months (mean, 8.2 months). At last follow-up, the two-point discrimination was 5.3-8.5 mm with an average of 6.98 mm. According to the evaluation standard of the upper limb part of the Chinese Medical Association, the score was 10-14, with an average of 12.5. Among them, 4 cases were excellent and 2 cases were good, with an excellent and good rate of 100%. All patients were satisfied with the function and appearance of thumb after operation. The Quick Disabilities of Arm, Shoulder, and Hand (Quick-DASH) score was 2.3-9.1, with an average of 6.1. ConclusionThe double osteotomy and lengthening of proximal phalanx and metacarpal with Ilizarov technique is an effective method for the treatment of thumb defects.

    Release date:2021-08-30 02:26 Export PDF Favorites Scan
  • 微型外固定支架重建掌指骨支架

    Release date:2016-09-01 09:25 Export PDF Favorites Scan
  • 指骨卡波西型血管内皮瘤复发一例

    Release date:2019-07-23 09:50 Export PDF Favorites Scan
  • Effectiveness of Kirschner wire fixation for proximal phalangeal bone avulsion fracture caused by A2 circular trochlea injury of flexor digitorum tendon

    Objective To explore the mechanism, surgical method, and effectiveness of proximal phalangeal bone avulsion fracture caused by A2 circular trochlea injury of the flexor digitorum tendon. Methods A retrospective analysis was conducted on the clinical data of 4 patients with proximal phalangeal bone avulsion fracture caused by A2 circular trochlea injury of flexor digitorum tendon admitted between May 2018 and September 2022. The patients were all male, the age ranged from 26 to 52 years, with an average of 33 years. The injured fingers included 1 case of middle finger and 3 cases of ring finger. The causes of injury were rock climbing of 2 cases and carrying heavy objects of 2 cases. Preoperative anteroposterior and lateral X-ray films and CT examination of the fingers showed a lateral avulsion fracture of the proximal phalanx, with a fracture block length of 15-22 mm and a width of 3-5 mm. The total active range of motion (TAM) of the injured finger before operation was (148.75±10.11)°. The grip strength of the middle and ring fingers was (15.50±2.88) kg, which was significantly lower than that of the healthy side (50.50±7.93) kg (t=−8.280, P<0.001). The time from injury to operation was 2-7 days, with an average of 3.5 days. One Kirschner wire with a diameter of 1.0 mm was used for direct fixation through the fracture block, while two Kirschner wires with a diameter of 1.0 mm were used for compression fixation against the fracture block. The fracture healing was observed, and the TAM of the injured finger and the grip strength of the middle and ring fingers were measured. The finger function was evaluated according to the upper limb functional assessment trial standards of the Chinese Medical Association Hand Surgery Society. ResultsThe incisions all healed by first intention after operation. All patients were followed up 6-28 months, with an average of 19 months. X-ray films showed that all avulsion fractures of proximal phalanx reached bony union, and the healing time ranged from 4 to 8 weeks, with an average of 4.6 weeks. At last follow-up, the grip strength of the middle and ring fingers was (50.50±7.76) kg, which significantly improved when compared with preoperative one (t=−8.440, P<0.001). The TAM of the injured finger reached (265.50±2.08)°, and there was a significant difference when compared with preoperative one (t=−21.235, P<0.001). According to the upper limb functional assessment trial standards of the Chinese Medical Association Hand Surgery Society, the finger function was all evaluated as excellent in 4 cases. ConclusionUsing Kirschner wire fixation through bone blocks and external compression fixation of bone blocks for treating proximal phalangeal bone avulsion fracture caused by A2 circular trochlear injury of the flexor digitorum tendon can achieve good effectiveness.

    Release date:2024-06-14 09:42 Export PDF Favorites Scan
  • 克氏针双夹扣法固定治疗远节指骨背侧基底不稳定骨折

    目的总结克氏针双夹扣法固定治疗远节指骨背侧基底不稳定骨折的疗效。 方法2008年9月-2014年3月,对15例远节指骨背侧基底不稳定骨折患者采用切开复位、克氏针双夹扣法固定。男12例,女3例;年龄18~53岁,平均32.5岁。致伤原因:戳伤8例,扭伤2例,摔伤3例,挤压伤2例。损伤指别:示指5例,中指3例,环指2例,小指5例。受伤至手术时间2~9 d,平均3.8 d。 结果患者术后切口均Ⅰ期愈合。15例均获随访,随访时间6~20个月,平均12.5个月。X线片示骨折均愈合,愈合时间5~8周,平均6.1周。术后8~12周,平均9.2周取出内固定物。末次随访时,根据总主动活动度(TAM)评价标准评定手指功能,获优9例,良5例,中1例,优良率93.3%。 结论克氏针双夹扣法固定治疗远节指骨背侧基底不稳定骨折,可使骨折、关节复位且固定牢固,允许手指早期功能锻炼,是一种有效治疗方法。

    Release date: Export PDF Favorites Scan
  • Clinical Research of Mini-plate for the Treatment of Metacarpal and Phalangeal Fractures and Early Rehabilitation

    ObjectiveTo discuss the clinical curative effect of internal fixation for metacarpal and phalanx fractures using stainless steel mini-plate and the early rehabilitation. MethodsThe study included 47 cases treated from January 2006 to June 2011, including 25 cases of 72 phalangeal fractures, 17 cases of 43 metacarpal fractures, and 5 cases of 23 complex metacarpal and phalangeal fractures. All the patients underwent open reduction and micro-plate internal fixation. Three days after surgery, passive function training was initiated. Patients accompanied with blood vessel damage began the training one week later. The training was carried out based on the early rehabilitation schedule. ResultsPrimary healing occurred in all the 47 cases. There was one case of broken plate because of crashing. Postoperative follow-up lasted for 4 to 10 months, and the fractures were healed in 138 lesions. X-ray examination showed that bone union took place at week 8 to 11 averaging at 10. According to the functional evaluation of total autive movement scales, the excellent and good rate was 83.0%. ConclusionThe stainless steel mini-plate in the treatment of metacarpal and phalangeal fractures has a firm fixation and is advantageous. Combined with early rehabilitation training, it can maximize the recovery of hand function with satisfactory clinical results.

    Release date: Export PDF Favorites Scan
2 pages Previous 1 2 Next

Format

Content