小切口掌侧截骨结合骨水泥外固定支架治疗第5掌骨颈骨折畸形愈合  

Small incision osteotomy via palmar approach combined with external fixator with bone cement for the treatment of malunion of the fifth metacarpal neck fracture

作　　者：杨易朋 田雅峰 樊金瑞 周海 惠红超 YANG Yi-peng;TIAN Ya-feng;FAN Jin-rui;ZHOU Hai;HUI Hong-chao(Department of Orthopaedics and Traumatology,Hebei Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China)

机构地区：[1]河北省中医院骨伤一科,河北石家庄050000

出　　处：《河北医科大学学报》2024年第1期24-28,共5页Journal of Hebei Medical University

摘　　要：目的 探讨小切口掌侧截骨结合骨水泥外固定支架治疗第5掌骨颈骨折畸形愈合的临床效果。方法 采用小切口掌侧截骨结合骨水泥外固定支架治疗第5掌骨颈骨折畸形愈合患者27例,通过术后6个月以上随访,评价外观指标、功能指标以及总体满意度等。结果 术后随访时间6~12个月,平均(8.6±2.1)个月。所有患者术后8~21周均达到骨性愈合,未出现内固定物断裂、深部切口感染、骨折不愈合等并发症。术后第5掌骨长度、第5掌指关节伸直角度、第5掌指关节活动度、拇小指捏力、拇小指握力、患者满意度评分等指标均明显优于术前(P<0.05)。结论 小切口掌侧截骨结合骨水泥外固定支架治疗第5掌骨颈骨折畸形愈合,手术方法安全有效,极大改善了患者的手部外观及功能,值得推广。Objective To investigate the clinical effect of small incision osteotomy via palmar approach combined with external fixator with bone cement in the treatment of malunion of the fifth metacarpal neck fracture.Methods Small incision osteotomy via palmar approach combined with external fixator with bone cement was used to treat 27 patients with malunion of the fifth metacarpal neck fracture.Through follow-up for more than 6 months after operation,the appearance index,functional index and overall satisfaction of the patients were evaluated.Results The duration of follow-up was 6-12 months,with an average of(8.6±2.1) months.All patients achieved bony union at 8-21 weeks after operation,without complications such as fracture of internal fixation,deep wound infection or nonunion of fracture.The length of the fifth metacarpal bone,the extension angle of the metacarpophalangeal joint,the range of motion of the fifth metacarpophalangeal joint,the pinch force and the grip strength of the thumb and little finger,and patient satisfaction score after the operation were significantly better than those before operation(P<0.05).Conclusion Small incision osteotomy via palmar approach combined with external fixator with bone cement for the treatment of malunion of the fifth metacarpal neck fracture is a safe and effective method,which greatly improves the appearance and function of the patient's hand,and is worthy of clinical promotion.

关 键 词：掌骨 骨折 连接错位 截骨术 骨水泥外固定架 

分 类 号：R683.418[医药卫生—骨科学]