论文部分内容阅读
目的:报告治疗末节指骨开放性骨折伴甲床损伤方法的可行性及疗效。方法:自2016年6月至2018年8月对我院急诊收治的28例34指末节指骨开放性骨折伴甲床损伤的患者,彻底清创后使用1~2枚7号注射器针头自末节指端甲床下方或侧方旋入,直视下髓内固定骨折端。裂伤甲床原位复位后不缝合,使用5 ml注射器针筒制作甲模板(若原甲板完好可修剪后备回植使用)覆盖于甲床表面,并缝线固定,术后3周拆除甲模板,术后4~6周拔除注射器针头,观察骨折愈合和指甲生长情况。结果:术后随访3~18个月,所有创面均Ⅰ期愈合,无感染和骨不连发生;指甲再生结果评定:优25指,良6指,可2指,差1指;优良率91.2%。手指屈伸功能结果:优26指,良4指,可3指,差1指;优良率88.2%。结论:注射器针头固定末节指骨骨折方法可靠,注射器针筒制作的甲模板覆盖裂伤的甲床对预防术后指甲畸形方法简单、效果显著。“,”Objective:To report the feasibility and efficacy of the treatment of open fracture of the distal phalanx with nail bed injury.Methods:From June 2016 to August 2018, 28 patients with open fracture of the distal phalanx of 34 fingers with nail bed injury admitted to the emergency department of our hospital were treated. After thorough debridement, one or two No.7 syringe needles were used to screw from the bottom or side of nail bed through the fingertip, and the fracture end was fixed by intramedullary fixation under direct vision. After nail bed reduction in situ without suture, nail template was made with 5 ml syringe barrel (if the original nail was intact, it could be trimmed and replanted) and covered the surface of the nail bed. The nail template was removed 3 weeks after operation, and the syringe needle was removed 4 to 6 weeks after operation to observe fracture healing and nail growth.Results:All the patients were follow-up for 3 to 18 months, and all wounds achieved primary healing. No infection or nonunion occurred. The nail regeneration was evaluated as excellent in 25 fingers, good in 6 fingers, fair in 2 fingers, and poor in 1 finger, with the excellent and good rate being 91.2%. The finger flexion and extension function was rated as excellent in 26 fingers, good in 4 fingers, fair in 3 fingers, and poor in 1 finger, with the excellent and good rate being 88.2%.Conclusion:The method of fixing the fracture of the distal phalanx with syringe needle is reliable. The nail template made by syringe needle barrel covering the lacerated nail bed is simple and effective in preventing nail deformity after operation.