经尺背侧入路结合自制克氏针拉钩复位固定治疗Bennett骨折  

Application of self-prepared Kirschner wire retractor reduction and internal fixation through ulnar dorsal approach for the treatment of Bennett fractures

作　　者：毛炳炎 李蕾 王文聪[1] 胡志喜[1] 贺用礼[1] 王强[1] 唐举玉[2] Mao Bingyan;Li Lei;Wang Wencong;Hu Zhixi;He Tongli;Wang Qiang;Tang Juyu(Department of Orthopedic Surgeiy, Shimen Hospital Affiliated to Changsha Medical University, Changde 415300, China;Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha 410008, China)

机构地区：[1]湖南长沙医学院附属石门医院骨科,常德415300 [2]中南大学湘雅医院手显微外科,长沙410008

出　　处：《中华手外科杂志》2019年第3期203-205,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨经尺背侧入路结合自制克氏针拉钩复位固定治疗Bennett骨折的临床疗效。方法自2014年7月至2018年2月收治13例Bennett骨折患者,设计第一腕掌关节尺背侧入路暴露骨折以及关节面,以自制克氏针拉钩辅助复位,以克氏针固定骨折。术后早期功能锻炼,4~6周后拔除克氏针。结果13例患者术后随访6~24个月,平均14.6个月,手术切口均Ⅰ期愈合,所有患者均获得骨性愈合,术后10周恢复创伤前活动水平。VAS疼痛评分0~3分,平均1.46分;手指关节总主动活动度TAM系统评定患指功能:优H例,良2例。1例患者岀现针道处红肿,其余患者均未出现针道感染、周围软组织激惹、克氏针松动、关节再脱位等并发症。结论经尺背侧入路结合自制克氏针拉钩复位固定Bennett骨折方法简单,疗效可靠,值得临床推广应用。Objective To explore the clinical efficacy of self-prepared Kirschner wire retractor reduction and internal fixation through ulnar dorsal approach in the treatment of Bennett fractures. Methods From July 2014 to February 2018, 13 patients with Bennett fractures were treated. The first carpometacarpal ulnar dorsal approach was designed to expose the fracture and articular surface. The reduction was performed using self-prepared Kirschner wire retractor, and then the fracture was fixed with Kirschner wires. Early functional exercise was performed after the operation, and Kirschner wire was removed after 4 to 6 weeks. Results All the patients were follow-up for 6 to 24 months postoperatively with an average of 14.6 months. All the incisions achieved primary healing. Bone healing was achieved in all the patients, and the pre-traumatic activity was restored 10 weeks after the operation. The VAS score ranged from 0 to 3 with an average of 1.46. The function of affected finger was evaluated by total active motion (TAM) assessment and the results were rated as excellent in 11 cases and good in 2 cases. One patient had redness and swelling in the needle track, while the other patients had no complications such as infection of the needle track, irritation of surrounding soft tissue, loosening of Kirschner needle and re-dislocation of joint. Conclusion The method of reduction and fixation of Bennett fractures through ulnar dorsal approach using self-prepared Kirschner wire retractor proves to be simple and reliable, which is worthy of clinical application.

关 键 词：骨折 治疗结果 内固定器 复位 

分 类 号：R683.41[医药卫生—骨科学]