加压交叉锁定克氏针固定法治疗指(趾)骨颈双髁骨折的疗效分析  

Compression fixation with cross-locking Kirschner wires for bicondylar fractures of the phalangeal neck in fingers(toes)

作　　者：杨继国 顾仕林[1] 刘冲 Yang Jiguo;Gu Shilin;Liu Chong(Department of Hand and Foot Surgery,Taizhou Hospital,Taizhou 318050,China)

机构地区：[1]浙江省台州医院手足外科,台州318050

出　　处：《中华创伤骨科杂志》2025年第1期84-87,共4页Chinese Journal of Orthopaedic Trauma

基　　金：台州市科技计划项目(24ywb69);台州市路桥区科技计划项目(2023S1008)。

摘　　要：目的探讨加压交叉锁定克氏针固定法治疗指(趾)骨颈双髁骨折的疗效。方法回顾性分析2019年2月到2023年8月浙江省台州医院手足外科收治的15例指(趾)骨颈双髁骨折患者资料,均应用加压交叉锁定克氏针固定法治疗。男13例,女2例;年龄(43.4±11.0)岁;手部9例,足部6例,其中骨块骨折线完全位于侧副韧带止点(髁侧隐窝)以远2例。记录患者骨折愈合时间、术后3个月疼痛视觉模拟评分(VAS)、末次随访时手部患者的手指总活动度(TAM)和并发症发生情况。结果所有患者术后获(5.4±3.0)个月随访。术后3个月所有患者疼痛VAS评分为0(0,0)分。术后3个月仅2例手部患者轻微疼痛(VAS评分分别为1、2分)。随访12个月时1例足部患者仍有轻微疼痛(VAS评分为1分),余5例足部患者负重无疼痛,正常行走步态。术后4、6、8周X线片结果示1例环指中节指骨关节内骨折不愈合,伴有骨质吸收,关节僵硬,未进一步处理。其余均骨性愈合,愈合时间为(7.1±1.9)周。末次随访时8例手部患者采用手指TAM评分系统评估:优6例,良2例。无骨折移位、克氏针松动退针和针道感染发生。结论加压交叉锁定克氏针固定法治疗指(趾)关节内双髁骨折技术具有操作简单、侵入性小、稳定性佳、便于术后早期康复等优点。ObjectiveTo investigate the efficacy of compression fixation with cross-locking Kirschner wires in the treatment of bicondylar fractures of the phalangeal neck in fingers(toes).MethodsA retrospective study was conducted to analyze the clinical data of 15 patients with bicondylar fractures of the phalangeal neck in fingers(toes)who had been treated from February 2019 to August 2023 at Department of Hand and Foot Surgery,Taizhou Hospital.The patients were all treated by compression fixation with cross-locking Kirschner wires.They were 13 males and 2 females with an age of(43.4±11.0)years and with 9 hands and 6 feet involved.In 2 of them,the fracture line of the bone block was completely located far from the insertion point of the lateral collateral ligament(condylar lateral recess).After surgery,no additional external fixation was used for all but 2 patients whose bone fold line was fixed with plaster for 3 to 4 weeks at a distance from the lateral collateral ligament insertion point.Follow-up records included fracture healing time,visual analogue scale(VAS)pain score at postoperative 3 months,total active motion(TAM)of the finger for hand patients at the final follow-up,and surgical complications.ResultsAll patients were followed up for(5.4±3.0)months.The VAS pain score for all patients was 0(0,0)point at postoperative 3 months.Only 2 patients reported mild pain in the hand at 3 months postoperatively(their VAS pain score was 1 or 2 respectively).At 12-month follow-up,1 foot patient reported mild pain(1 point of VAS)and the other 5 foot patients experienced no pain while they were carrying weights and walking normally.X-ray evaluations at postoperative 4,6,and 8 weeks showed nonunion of a middle phalanx intra-articular fracture of the ring finger in 1 case,complicated by bone resorption and joint stiffness which were not further treated.The other cases achieved bony union after an average healing time of(7.1±1.9)weeks.Of the 8 hand patients whose total active motion was measured at the final follow-up using the

关 键 词：指骨 趾骨 骨折固定术 内 克氏针 交叉锁定 

分 类 号：R68[医药卫生—骨科学]