闭合复位平行克氏针固定治疗第1掌骨基底部骨折  

作　　者：冯炜[1] 李俊杰[1] 俞立新[1] 

机构地区：[1]浙江湖州中国人民解放军第98医院全军创伤修复重建中心,313000

出　　处：《浙江临床医学》2017年第2期266-267,共2页Zhejiang Clinical Medical Journal

摘　　要：目的探讨闭合复位平行克氏针固定治疗第1掌骨基底部骨折的方法及临床疗效。方法回顾性分析自2013年2月-2015年2月采用闭合复位第一、二掌骨间平行克氏针固定治疗第1掌骨基底部骨折24例，Ⅰ型（Bennett骨折）12例，Ⅱ型（Rolando骨折）6例，ⅢA型（关节外横行骨折）5例，ⅢB型（关节外斜行骨折）1例。结果24例术后均获得随访12-32个月，平均18个月。所有患者骨折均骨性愈合，愈合时间为8-12周，平均10周。末次随访时，VAS评分为（0．92±0．04）分；ATM系统评定法评价掌指关节功能：优16例，良7例，中1例，总体优良率为95．8％；Eaton—Littler分期评估创伤性关节炎：Ⅰ期16例，Ⅱ期7例，Ⅲ期1例。结论采用闭合复位第一、二掌骨间平行克氏针固定治疗第1掌骨基底部骨折具有操作简单、创伤小、固定可靠及费用低等优点，近期疗效满意，是治疗第1掌骨基底部骨折的有效方法，值得在基层医院推广。Objective To explore the method and clinical Results of closed reduction and parallel K-wire fixation for the base of the first metacarpal fractures. Methods From February 2013-February 2015, 24 cases of the base of the first metacarpal fractures were treated by closed reduction and parallel K-wire fixation, which included type Ⅰ （ Bennett fracture ） 12 cases, type Ⅱ （ Rolando fracture ） 6 cases, type mA （ extraarticular transverse fracture ） 5 cases, type ⅢB （ extra-articular oblique fracture ） 1 cases. Results All patients were successfully follow-up for 12 to 32 months, with an average of 18 months.All fractures got union.The union time were 8-12 weeks, with an average of 10 weeks.For the last follow-up, VAS score was （ 0.92-0.04 ） .According to the TAM system evaluation method, the results were excellent in 16 cases, good in 7, fair in 1, the total excellent and good rate was 95.8 % .Traumatic arthritis was evaluated by Eaton-Littler stage, which was graded Ⅰ period in 16 cases, Ⅱ period 7 cases, Ⅲ period in 1 case. Conclusions Closed reduction and parallel K-wire fixation is an ideal way to treat the base of the first metacarpal fractures, which has advantages of simple, minimal invasive reliable fixation and cheap.

关 键 词：掌骨骨折 闭合 克氏针 

分 类 号：R683.410.5[医药卫生—骨科学]