相邻掌骨横行固定联合克氏针直接固定治疗第五掌骨骨折  

Adjacent metacarpal transverse fixation combined with Kirschner wire direct fixation for the treatment ofthefifthmetacarpal fractures

作　　者：李栋超 杨法报 刘书强 Li Dongchao;Yang Fabao;Liu Shuqiang(Department of Hand and Foot Surgery,Liaocheng Hospital of Traditional Chinese Medicine,Liaocheng 252004,China)

机构地区：[1]聊城市中医医院手足外科,聊城252004

出　　处：《中华手外科杂志》2024年第5期390-393,共4页Chinese Journal of Hand Surgery

摘　　要：目的 探讨相邻掌骨横行固定联合克氏针直接固定治疗第五掌骨骨折的疗效.方法 我院自2020年1月至2023年1月对42例第五掌骨骨折患者,采用相邻掌骨横行固定联合克氏针直接固定治疗,术后评估患手功能恢复情况,记录骨折愈合情况、克氏针拔除时间及手功能恢复情况.结果 本组病例术后随访3~12个月,平均6个月,骨折愈合时间4~8周,平均6周,拔除克氏针,所有患者各指间关节屈伸活动度较对侧正常,掌指关节活动度(86.5±3.5)°,3例基底部位骨折疼痛,经康复治疗后疼痛减轻或消失.根据TAM评定标准评分:优35例,良4例,可3例;优良率92.8%.结论 相邻掌骨横行固定联合克氏针直接固定适用于未累及掌指关节面及极远头下部位的第五掌骨单一段骨折,固定牢靠,能够早期进行康复锻炼,操作简便,手术时间短,无需二次切开取出,便于推广应用.Objective To explore the clinical efficacy of adjacent metacarpal transverse fixation combined with Kirschner wire direct fixation for the treatment of the fifth metacarpal fractures.Methods From January 2020 to January 2023,42 patients with the fifth metacarpal fractures were treated using adjacent metacarpal transverse fixation combined with Kirschner wire direct fixation.The postoperative evaluation was conducted on the recovery of hand function,including fracture healing,Kirschner wire removal time,and hand function recovery.Results The postoperative follow-up ranged from 3 to 12 months,with an average of 6 months.The fracture healing time was 4 to 8 weeks,with an average of 6 weeks.The Kirschner wire was removed,and the range of motion of the interphalangeal joints was normal compared to the contralateral side.The range of motion of the metacarpophalangeal joint was(86.5±3.5)°.Three cases had pain in the basal area of the fracture,which was relieved or disappeared after rehabilitation treatment.According to the TAM evaluation criteria,35 cases were rated as excellent,4 cases as good,and 3 cases as fair,with an excellent and good rate of 92.8%.Conclusion The combination of transverse fixation of adjacent metacarpal bones and direct fixation with Kirschner wires is suitable for single segment fractures of the fifth metacarpal bone that do not involve the metacarpophalangeal joint surface or the distal head area.The fixation is reliable,early rehabilitation exercise can be carried out,the operation is simple,the surgical time is short,and there is no need for secondary incision and removal,making it suitable for promotion and application.

关 键 词：掌骨 骨折 克氏针 横行固定 

分 类 号：R687.3[医药卫生—骨科学]