闭合复位伸直位外固定治疗68例Boxer骨折临床疗效观察  

Clinical Observation of 68 Cases of Boxer Fracture Treated with Closed Reduction and External Fixation in the Extended Position

作　　者：郝博川 谢克波[1] 张君松[1] 张雷[1] 郑移兵[1] 廖颖翀 鲍树仁 HAO Bochuan;XIE Kebo;ZHANG Junsong(Beijing Fengsheng Special Hospital of Traditional Medicine Traumatology and Orthopedics,Beijing 100034,China)

机构地区：[1]北京市丰盛中医骨伤专科医院,北京100033

出　　处：《航空航天医学杂志》2023年第4期385-387,共3页Journal of Aerospace medicine

摘　　要：目的探讨手法闭合复位硬纸夹板外固定治疗5掌骨颈骨折的临床疗效。方法对2015年09月-2019年09月收治的68例有明显背侧成角畸形、旋转不稳定的第5掌骨颈骨折患者进行回顾性研究,均采用闭合复位伸直位硬纸夹板外固定;拆除外固定后早期进行康复功能锻炼。经过闭合复位治疗,对比治疗的前、后以及随访中相应的X线片,对骨折复位以及相应畸形纠正情况进行评判;对第五掌骨的头干角进行测量;依据中华医学会中对应的手外科学会的上肢部分功能进行评定标准中的手指总主动活动度(total active motion,TAM)测定法评价术后相应手功能恢复情况。结果整复术后病人都在一期愈合,68例都被随访,大体随访时间为6-12个月,治疗后无骨折不愈合及延迟愈合,整复后后头干角为16.8°±2.4°,与术前的57.1°±14.7°比较,差异有统计学意义(P<0.05);术后TAM为79.2°±8.9°,优58例,良10例,优良率为100%,关节活动恢复基本正常。结论该种固定方法的设计符合生物力学原理,使用方便,临床应用效果满意。Objective To study the technique fixed outside the closed reduction was the fifth metacarpal neck fracture clinical curative effect.Methods From September 2015 to September 2019,68 cases of the fifth metacarpal neck fracture with obvious dorsolateral angulation and unstable rotation were retrospectively studied.All of them were fixed with closed reduction and straight position hard paper splint.After the external fixation was removed,rehabilitation exercise was carried out early.Through the X-ray films before,after and during the follow-up of the closed reduction treatment,the fracture reduction and deformity correction were evaluated;the angle of the fifth metacarpal head was measured;according to the total active motion(TAM)measurement method of the upper limb function evaluation standard of the hand surgery society of the Chinese Medical Association,the hand function recovery after the operation was evaluated.Results 68 cases were followed up for 6-12 months.There was no nonunion or delayed union after treatment.The angle of the trunk of the head was 16.8°±2.4°after the operation,which was significantly different from 57.1°±14.7°before the operation(P0.05).The TAM was 79.2°±8.9°after the operation,58 cases were excellent,10 cases were good,the excellent rate was 100%,and the joint activity was basically normal.Conclusions The method of this kind of fixed conforms to biomechanical principle,easy to use,clinical effect is satisfied.

关 键 词：手法整复 伸直位硬纸夹板 外固定 第五掌骨颈骨折 

分 类 号：R729[医药卫生—儿科]