22 KB607 KB21 KB192920262001Margić, Krunoslavštevilka:11letnik:70str. 665-670ISSN:1318-0347COBISSID:14274009URN:URN:NBN:SI:doc-ASQDICLKslSlovensko zdravniško društvoZdravniški vestnikdlančniceExternal fixatorsFracture fixationInjuriesIzid zdravljenjaMetacarpophalangeal jointMetacarpusMetakarpofalangealni sklepMetakarpuspoškodberokatherapyTreatment outcomezdravljenjeZlom, fiksacijazlomiZunanji fiksatorjiZunanje fiksiranje zlomov dlančnic in členkov| External fixation of metacarpal and phalangeal fractures|Background. In past three years we have used small external fixator in the treatment of 18 closed fractures of metacarpal bones, 15 phalangeal fractures,four dislocated fractures of MCP and five of PIP joint, ten arthrodesis, five replantations/revascularisations, two pathological fractures, and in few post-traumatic infection of bones and joints. Results. Results were graded as excellent (completely normal function), very good (15 degrees deficit of total ROM), good (30 degrees deficit of total ROM; can flexthe fingers to the palm), and poor. Excellent result was obtained in the treatment of all 18 metacarpal fractures. The final results in the treatment of 22 closed fragmentated fractures of phalanges were as follows: excellent 3,very good 2, good 2 and five poor results (three patients in this group havefallen on their hands causing refracture and reoperation). Three of four fractures of MCP joint and four of five fractures involving PIP joint have good mobility. In eight of ten patients arthrodeses are stable and without pain. In two cases pathological fractures were first stabilized and than the tumor was evacuated and grafted with minimal dissection; booth have good results. Conclusion. Author suggests that, in selected cases, with applicationof small external fixator reasonable good results can be obtainedIzhodišča. V zadnjih treh letih smo majhen zunanji fiksator uporabili za stabilizacijo 18 zaprtih zlomov dlančnic, 15 zlomov členkov, štiri zlome metakarpofalangealnega in 5 zlomov proksimalnega interfalangealnega sklepa, deset artrodez, pet revaskularizacij oz replantacij, dva patološka zloma in pri zdravljenju gnojnih vnetji kosti in sklepov. Rezultati. Rezultat smo ocenili kot odličen (popolna gibjivost), zelo dober (skupni primanjkljaj amplitude giba do 15), dober (skupni primanjkljaj do 30; bolnik lahko stisne prste do dlani) in slab. Rezultat zdravljenja vseh 18 zlomov dlančnic je bil odličen. Rezultati zdravljenja 12 zaprtih zlomov členkov so odlični 3, zelo dobra 2, dobra 2 in 5 slabih (trije bolniki so po odstranitvi fiksatorja ponovno poškodovali prst). Dobro gibjivost smo dosegli pri zdravljenju treh odštirih zlomov metakarpofalangealnega sklepa in pri štirih od petih zlomov proksimalnega interfalangealnega sklepa. Osem artrodez je stabilnih in nebolečih. V dveh patoloških zlomih smo zlom najprej reponirali in stabilizirali in potem odstranili tumor, oba imata dober rezultat. Zaključek. Avtor meni, da v izbrani skupini poškodb z zaprto repozicijo in zunanjo fiksacijo lahko dosežemo dobre rezultateTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo