微型外固定支架治疗第一掌骨基底部骨折经大多角骨进钉方式的研究

Study on the nailing path at trapezium of minor external fixation for treating the fracture at the basilar of the first metacarpal

摘要:

目的：优化微型外固定支架治疗第一掌骨基底部骨折时经大多角骨进钉的方式，以增加骨折固定的稳定性，并提出安全、明确的手术操作。方法：对腕部大多角骨行计算机断层扫描（computed tomography，CT）影像行多平面重建成像（multi-planer reconstruction，MPR），对大多角骨三维平面反映大多角骨的各项数值进行测量，根据测量值分析在大多角骨的钉道优化设计与可行性。结果：总计测量60例正常大多角骨的CT数据值，其中男女各30例，平均年龄42.3岁，测得其桡侧宽度为（13.46±1.13） mm，高度为（11.43±1.18） mm，减深距为（7.38±0.98） mm，矢状长度为（14.59±1.63） mm，根据测得的值定位钉道。结论：大多角骨骨体的大小能满足钉道优化设计的需求；大多角骨的测量值能评估钉道的安全范围，指导手术操作。

Abstract:

Objective：To optimize the nailing path at trapezium of mineral external fixation for treating the fracture at the basilar of the first metacarpal，which can build more stable fixation and present safe and accurate operation. Methods：We measured the values of trapezium at multidimension by researching the computed tomography（CT） images of the bone at the multi-planer reconstruction （MPR） images，and analyzed them about the optimized nailing path design and feasibility. Results：The CT values of 60 people’s nor－mal trapezium were measured，including 30 men and 30 women with average age of 42.3. The radialis width of trapezium is （13.46±1.13） mm，middle altitude is （11.43±1.18） mm，altitude above shorten sagittal diameter is （7.38±0.98） mm，sagittal length is （14.59±1.63） mm. The measured values were used in locating nail tract. Conclusion：Most of the sizes of trapezium can meet the requirement of the optimization of nailing path；most of the measured values of trapezium can be used to evaluate the safe range of nail tract and provide guidance for the operation.