U形克氏针穿针法治疗拇指近节指骨基底部尺侧撕脱性骨折的临床效果  

Clinical application of U type Kirschner needle penetration in treating ulnar avulsion fracture of the base of proximal phalanx of thumb

作　　者：郭亮 兰赛娇 吴学军 林金贵 林世备 黄顺毅 王志炜 郑益武 GUO Liang;LAN Saijiao;WU Xuejun(Department of Hand and Foot Microsurgery,Fuzhou Second Hospital Affiliated to Xiamen University,Fuzhou,Fujian,350007,China)

机构地区：[1]厦门大学附属福州第二医院手足显微外科,福建福州350007 [2]福建中医药大学骨伤科,福建福州350122

出　　处：《实用手外科杂志》2023年第1期12-16,共5页Journal of Practical Hand Surgery

基　　金：福建省创伤骨科急救与康复临床医学研究中心项目(项目编号:2020Y2014)。

摘　　要：目的探究U形克氏针穿针法治疗拇指近节指骨基底部尺侧撕脱性骨折的临床疗效。方法回顾性分析2018年1月-2020年12月收治的24例24指拇指近节指骨基底部尺侧撕脱性骨折的临床资料。所有患者均采用U形克氏针穿针法治疗,并记录术前、取出克氏针即刻、末次随访时掌指关节主动活动度、拇指外展角以及疼痛情况。疼痛情况采用疼痛视觉模拟评分法(Visual analogue scale,VAS)评定。结果所有患者术后均获得随访,随访时间3~10个月,平均(6.0±2.0)个月。骨折骨性愈合时间4~10周,平均(7.1±1.7)周。从术前、取出克氏针即刻至末次随访,掌指关节主动活动度由12.5°±3.9°提高至81.1°±7.0°,拇指外展角由35.8°±3.1°提高至66.1°±2.8°,均显著提高(P<0.05);VAS评分由(6.8±1.1)分降至(1.9±1.3)分,显著下降(P<0.05)。全组病例除1例再发骨折外,其余第1掌指关节稳定,屈伸、外展功能及捏、握能力正常。结论U形克氏针穿针法治疗拇指近节指骨基底部尺侧撕脱性骨折可显著改善患者功能及疼痛,是一种微创、简便、并发症少的手术方法。Objective To explore the clinical effect of U type Kirschner needle penetration on ulnar avulsion fracture of the base of proximal phalanx of thumb.Methods Twenty-four patients(24 fingers)with ulnar avulsion fracture of the base of proximal phalanx of thumb admitted to our hospital from January 2018 to December 2020 were retrospectively analyzed.All patients were treated with U type Kirschner needle penetration.The range of motion,abduction angle and pain of metacarpophalangeal joint were evaluated at preoperative,immediately after Kirschner needle extraction and at the last follow-up.The pain was assessed using visual analogue score(VAS).Results All patients in this study were followed up,followed up for 3~10 months(mean 6.0±2.0 months).The bone union time was 4~10 weeks,with an average of 7.1±1.7weeks.The motion range of metacarpophalangeal joint was increased from 12.5±3.9 to 81.1±7.0,and the abduction angle was increased from 35.8±3.1 to 66.1±2.8(P<0.05).VAS was significantly decreased from 6.8±1.1 to 1.9±1.3(P<0.05);one patient suffered another fracture,the remaining metacarpophalangeal joint was stable and the flexion and extension,abductive function and pinching and gripping ability were normal.Conclusion The U type Kirschner needle penetra-tion method can make the functional recovery better and the pain significantly decreases from avulsion fractures of the ulnar collateral ligament of the thumb metacarpophalangeal joint.It is a minimally invasive,simple surgical method with less complications.

关 键 词：指骨骨折 撕脱性骨折 克氏针 微创 

分 类 号：R687.3[医药卫生—骨科学]