闭合复位加经皮克氏针固定治疗不稳定性第5掌骨颈骨折  

Treatment of the fifth metacarpal neck unstable fracture with the closed reduction and the percutaneous K-wire fixation

作　　者：蔡灵敏 郭翱[1] 金岩泉 郑良军[1] CAI Lingmin GUO Ao JIN Yanquan et al(Taizhou Hospital of Boue Fracture of Zhejiang Province, Wenling, Zhejiang, 317500, China)

机构地区：[1]浙江省台州骨伤医院,浙江温岭317500

出　　处：《实用手外科杂志》2017年第2期193-195,共3页Journal of Practical Hand Surgery

摘　　要：目的 探讨及评价采用闭合复位加经皮克氏针固定不稳定性第5掌骨颈骨折的临床疗效.方法 2011年7月-2014年12月,采用闭合复位加经皮克氏针固定治疗不稳定性第5掌骨颈骨折20例,骨折闭合复位后,先用两枚克氏针于骨折远、近端横向阻挡上下骨干,若骨折线为短斜形,可加用一枚克氏针斜向固定,术后可早期活动.结果 12例获得解剖复位,8例近解剖复位,骨折对线良好.3例出现针道局部感染,经换药后控制,余17例伤口均Ⅰ期愈合.术后随访3~10个月,平均6个月,所有骨折于术后1个月左右有骨痂形成,2.5个月左右达骨性愈合,所有病例无手指旋转畸形,无骨不愈合及骨不连发生.结论 闭合复位加经皮克氏针固定治疗移位第5掌骨颈骨折,手术方法简单、创伤小、对骨折部位的二次损伤小,并发症少,疗效确定.Objective To study and evaluate the clinical efficacy of percutaneous K-wire fixation, and the closed reduction to treat the fifth metacarpal neck unstable fracture. Methods From July 2011 to December 2014, closed reduction with the Kirschner wire internal fixation were used to treat the fifth metacarpal neck unstable fracture in 20 cases, after closed reduction of fracture, Firstly 2 Kirschner wires were used in the proximal and distal part of tracture to transversly block superior and inferior bone shaft. If the fracture line was short oblique, oblique fixation was taken by 1 Kirschner needle and early exercise after operation. Results 12 cases obtained anatomical reduction, 8 cases were close to anatomical reduction, fracture line was good. There were 3 cases of patients with local infection, was controlled after dressing, and the remaining 17 cases of wounds were primary healing. The patients were followed up for 3-10 months, with an average of 6 months. All fractures had callus formation on the 1st month after operation and got osteal healing on the 2nd month. All cases had no digital rotation deformity, no nonunion occured. Conclusion closed reduction and Kirschner wire internal fixation for the treatment of the displaced fifth metacarpal neck fracture has advantagede such as ： surgical method is simple, less trauma, less secondary injury, less complications, curative effect is definite.

关 键 词：掌骨颈骨折 闭合复位 克氏针 

分 类 号：R683.41[医药卫生—骨科学]