内生软骨瘤是手部最常见的骨肿瘤,其症状主要为病变部位的肿胀、疼痛和畸形.内生软骨瘤与软骨肉瘤的鉴别诊断较困难.内生软骨瘤的治疗方法可分为保守治疗和手术治疗.目前,对于手术辅助物使用、术后空洞的处理以及合并病理性骨折患者手术时机选择仍存在争议.该文就手部内生软骨瘤的治疗进展进行综述.

Objective To explore the clinical efficacy of absorbable rod in the treatment of metacarpal fractures under the guidance of accelerated rehabilitation surgery concept.Methods From August 2016 to August 2018,53 patients with long oblique and spiral metacarpal fractures were treated with absorbable rod by fixation perpendicular to the fracture line.The patients were divided into observation group and control group according to whether they were treated with the concept of accelerated rehabilitation surgery during perioperative period or not.There were 24 cases in the observation group (28 places) and 29 cases in the control group (31 places).The visual analogue scale (VAS) on the first day after operation,the time when the active range of motion of metacarpophalangeal joint returned to normal,the time of fracture healing and the functional evaluation results of the injured hand at the last follow-up were compared between the two groups.Results All the patients were follow-up for 1 to 12 months with an average of 9.2 months.All the incisions achieved primary healing and all the fractures were healed.On the first day after operation,VAS and the recovery time of metacarpophalangeal joint activity in the observation group were (2.64±0.81) points and (19.35±2.12) days,respectively,which were significantly lower than those in the control group (3.42± 1.13) points and (28.63± 1.31)days.The differences were statistically significant (t=-2.920,-14.665,P＜0.05).The healing time of fracture in the two groups was (8.13±1.22) weeks and (8.41±1.16) weeks,respectively.There was no significant difference between the two groups (t=-0.850,P＞0.05).There was no significant difference in hand function evaluation between the two groups at the last follow-up (x2=0.045,P＞0.05).ConcIusion The technique of absorbable rod by fixation perpendicular to the fracture line for long oblique or spiral metacarpal fractures is a safe and effective surgical method.With the guidance of accelerated rehabilitation surgery concept,hand function can be better restored and satisfactory clinical efficacy can be obtained.