单根髓内克氏针固定第5掌骨颈再骨折  

Single intramedullary Kirschner wire for fixation of re-fracture of the fifth metacarpal neck

作　　者：董伟 王晓明 李新炜 DONG Wei;WANG Xiao-ming;LI Xin-wei(Weihaiwei People's Hospital,Weihai 264200,China)

机构地区：[1]威海卫人民医院,山东威海264200

出　　处：《中国矫形外科杂志》2022年第20期1900-1902,1906,共4页Orthopedic Journal of China

摘　　要：[目的]探讨单根髓内克氏针固定治疗第5掌骨颈骨折临床骨折愈合内固定取出后再骨折的临床疗效。[方法]2015年1月—2021年6月应用单根顺行2.0 mm髓内克氏针固定治疗第5掌骨颈骨折再骨折10例。总结围手术期、随访及影像资料。[结果]所有患者顺利完成手术,手术时间平均(18.60±2.88)min,术中微量出血,所有患者切口均愈合良好。随访时间平均(4.90±1.10)个月,术后随着时间推移,VAS、DASH评分显著降低(P<0.05),第五掌指ROM显著增加(P<0.05),随访过程中发现1例克氏针突破软骨下骨进入关节约2 mm,未完全制动,随访5个月骨折临床愈合。影像方面,与术前相比,术后3个月、末次随访时骨折复位对位、对线均显著改善(P<0.05)。末次随访骨折全部愈合,无内固定失效、松动、移位或断裂,无骨不连、畸形愈合等并发症。[结论]单根髓内克氏针固定治疗第5掌骨颈再骨折临床疗效满意。[Objective]To evaluate the clinical outcomes of single intramedullary Kirschner wire for fixation of re-fracture of the fifth metacarpal neck secondary to primary internal fixation.[Methods]From January 2015 to June 2021,10 patients received internal fixa⁃tion with a single 2.0 mm intramedullary Kirschner wire for re-fracture of the fifth metacarpal neck.The perioperative,follow-up and imag⁃ing data were summarized.[Results]All studied patients had operation completed successfully with operation time of(18.60±2.88)min,whereas without serious complications such as reduction loss,infection,bone nonunion,tendon stimulation and joint stiffness.As time went in follow-up lasted for 3~6 months with a mean of(4.90±1.10)months,VAS and DASH scores,as well as metacarpophalangeal range of mo⁃tion(ROM)significantly improved(P<0.05).Radiographically,the excellent fracture reduction at 3 months after operation and the last fol⁃low-up was 90%,additionally,fracture healing achieved in 40%at 3 months,while 100%at the last follow-up(P<0.05).[Conclusion]The single intramedullary Kirschner wire fixation for re-fracture of fifth metacarpal neck does achieve satisfactory clinical consequences.

关 键 词：髓内针 掌骨颈 再骨折 

分 类 号：R683.41[医药卫生—骨科学]