关节镜辅助下经皮螺钉内固定治疗Bennett骨折

摘要

目的 探讨关节镜辅助下经皮螺钉内固定治疗Bennett骨折的临床疗效、影像学结果和并发症.方法 2009年5月—2015年5月,采用关节镜辅助下经皮螺钉内固定治疗Bennett骨折患者51例(51手),其中男性40例,女性11例;年龄(38.7±12.4)岁;体重指数(23.7±8.1)kg/m2.记录并评估并发症发生率、骨折愈合时间、第一腕掌关节有效活动度评分(Kapandji Score)、握力、捏力、关节面复位及内固定移位情况等.结果 51例患者均获得随访,随访时间(33.8±9.9)个月.骨折愈合时间为(5.9±1.8)周;第一腕掌关节有效活动度评分为(9.8±0.2)分;握力为(46.7±4.2)kg;捏力为(8.7±2.4)kg.所有患者均恢复创伤前工作状态,随访期间1例(2.0%)患者出现复杂性局部疼痛综合征,但不影响日常工作.术后即刻X线片检查,所有关节面均获得解剖复位,随访检查示所有骨折均获得骨性愈合,无一例患者出现关节退变及内固定移位.结论 采用关节镜辅助下经皮内固定治疗Bennett骨折,能够获得解剖复位,临床疗效和影像学结果满意,并发症发生率低.%Objective To summarize the clinical,radiographic outcomes and complications of arthroscopi-cally-assisted minimally invasive percutaneous screw fixation in treating Bennett fractures .Methods Fifty-one pa-tients (51 hands) with Bennett fractures were treated by arthroscopically-assisted minimally invasive percutaneous screw fixation between May 2009 and May 2015.There were 40 males and 11 females,with a mean age of (38.7 ± 12.4) years and a mean body mass index of (23.7 ±8.1)kg/m2.The data was recorded,including the incidence of complications,fracture union time,Kapandji Score for clinical function,grip and pinch strength,joint surface re-duction,and displacement of fixation material .Results All of 51 patients were followed up ,and the mean follow-up time was(33.8 ±9.9) months.The mean fracture union time was (5.9 ±1.8) weeks.The mean Kapandji Score was (9.8 ±0.2)points;and the mean grip and pinch strength was (46.7 ±4.2)kg and (8.7 ±2.4)kg,respective-ly.All patients recovered pre-traumatic work activities.One patient(2.0%) experienced a complex local pain syn-drome during follow-up,but did not affect daily work .Immediate postoperative X-ray images showed that all patients achieved anatomic reduction of joint surfaces .All fractures obtained bone union ,and no patient had joint degenera-tion or displacement of screw . Conclusion The arthroscopically-assisted minimally invasive percutaneous screw fixation for Bennett fractures can achieve anatomic reduction of joint surfaces , satisfactory clinical and radiological outcomes,and a low rate of complication.