经皮克氏针改良髓内固定第5掌骨颈骨折疗效分析  

Modified percutaneous intramedullary fixation with Kirschner wire for treatment of the fifth metacarpal neck fracture

作　　者：贾赛雄[1] 吴迪[1] 李晓文[1] 利春叶[1] JIA Sai-xiong;WU Di;LI Xiao-wen;LI Chun-ye(Department of Upper Limb Microsurgery,Shenzhen Bao′an District People′s Hospital,Shenzhen Guangdong 518101,China)

机构地区：[1]广东省深圳市宝安区人民医院上肢显微外科,518101

出　　处：《蚌埠医学院学报》2020年第3期367-370,共4页Journal of Bengbu Medical College

摘　　要：目的:探讨经皮克氏针改良髓内固定第5掌骨颈骨折的治疗效果。方法:选择24例第5掌骨颈闭合骨折病人,按治疗方法分为对照组(n=11)和手术组(n=13)。对照组采用传统手法复位石膏外固定进行治疗,手术组采用闭合复位经皮克氏针改良髓内固定方法进行治疗。采用总主动活动度(TAM)系统评定法评定2组病人的功能恢复情况。结果:闭合复位经皮克氏针改良髓内固定手术时间为15~25 min,术后复查X线片提示骨折复位良好。TAM系统评定法评定结果显示,手术组:优10例,良3例;对照组:优3例,良4例,可4例。2组治疗效果差异有统计学意义(uc=2.40,P<0.05)。术后手术组未出现针尾滑囊炎及尺神经手背支激惹或损伤。结论:闭合复位经皮克氏针改良髓内固定治疗第5掌骨颈骨折,手术简单易行,外固定时间短,创伤小,并发症少,效果满意,值得推广。Objective:To evaluate the effect of modified percutaneous intramedullary fixation with Kirschner wire for treatment of the fifth metacarpal neck fracture.Methods:A total of 24 patients with closed fracture of the fifth metacarpal neck were selected and divided into control group(n=11)and operation group(n=13)according to the treating method.The control group was treated with traditional reduction and plaster external fixation,and the operation group was treated with closed reduction and modified percutaneous intramedullary fixation with Kirschner wire.The total active movement(TAM)system was used to evaluate the functional recovery of the two groups.Results:The operation time of closed reduction and modified percutaneous intramedullary fixation with Kirschner wire was 15 to 25 minutes.The X-ray examination after operation indicated that the fracture was restored well.The results of TAM system showed that there were 10 excellent cases and 3 good cases in operation group,and 3 excellent cases,4 good cases and 4 fair cases in control group,and the difference of the therapeutic effect between two groups was statistically significant(uc=2.40,P<0.05).There was no irritation or injury of the dorsal branch of the ulnar nerve after operation in operation group.Conclusions:Closed reduction and improved percutaneous intramedullary fixation with Kirschner wire for the treatment of the fifth metacarpal neck fracture is simple and easy to operate,with short external fixation time,minimal trauma,fewer complications and satisfactory results,which is worth popularizing.

关 键 词：掌骨颈骨折 克氏针 经皮髓内固定 尺神经手背支 

分 类 号：R683.41[医药卫生—骨科学]