横行支撑髓内固定技术治疗第五掌骨颈骨折43例  

Treatment of 43 Cases of Neck Fracture of Fifth Metacarpal Bone by Transverse Support Intramedullary Fixation

作　　者：谭新欢 王崧伊 王飞 侯金永 于满秋 宫大伟 段来宝 吴青松 查卿[2] 毕宏政 TAN Xinhuan;WANG Songyi;WANG Fei;HOU Jinyong;YU Manqiu;GONG Dawei;DUAN Laibao;WU Qingsong;ZHA Qing;BI Hongzheng(Wendeng Hospital of Traditional Chinese Orthopedics and Traumatology of Shandong Province,Weihai 264400,Shandong China;Chinese Academy of Sciences Suzhou Institute of Biomedical Engineering,Suzhou 215100,Jiangsu China)

机构地区：[1]山东省文登整骨医院,山东威海264400 [2]中国科学院苏州生物医学工程技术研究所

出　　处：《中国中医骨伤科杂志》2025年第2期71-75,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：国家中医药管理局科技司-山东省卫生健康委员会共建中医药科技项目(GZY-KJS-SD-2023-030);山东省中医药科技项目(Z-2023032T);全国名老中医药专家传承工作室(国中医药人教函[2022]75号)。

摘　　要：目的:观察横行支撑髓内固定技术治疗第五掌骨颈骨折的临床疗效和安全性。方法:回顾性分析2020年1月至2023年11月收治的43例第五掌骨颈骨折患者的病例资料,其中男34例,女9例;年龄为18~58岁,平均为(36.7±6.9)岁;受伤至手术时间为2~6 d,平均为3.5 d。所有患者均采用横行支撑髓内固定技术治疗。随访观察并发症发生情况,将术前及末次随访的颈干角进行比较,末次随访根据手指总主动活动度(TAM)测定法进行疗效评定。结果:所有患者均顺利完成手术且骨折均愈合,术中无血管、神经损伤,术后无内固定松动、骨折端旋转及短缩移位等并发症;随访时间为6~12个月,平均为(9.47±3.15)个月;术前手掌骨颈干角平均为46.43°±10.38°,末次随访手掌骨颈干角平均为15.58°±1.24°,术后与术前比较差异有统计学意义(P<0.01);末次随访按手指总主动活动度测定法评定:优29例,良11例,可3例,差0例,优良率为93%。结论:横行支撑髓内固定技术治疗第五掌骨颈骨折具有操作简便、固定牢固、疗效确切的优点,是一种可行的微创治疗方案。Objective:To observe the clinical efficacy and safety of transverse support intramedullary fixation in the treatment of neck fracture of fifth metacarpal bone.Methods:The clinical data of 43 patients with neck fracture of fifth metacarpal bone admitted from January 2020 to November 2023 were retrospectively analyzed,including 34 males and 9 females.The age ranged from 18 to 58 years old,with an average age of(36.7±6.9)years old.The operative time from injury to operation was 2-6 d(mean 3.5 d).All patients were treated with transverse support intramedullary fixation.The complications were observed during the follow-up,and the cervical stem angle values were compared between the preoperative and the last follow-up,and the curative effect was evaluated according to the measurement of total active range of motion(TAM)in the last follow-up.Results:All patients successfully completed the operation and the fractures were healed,and there were no vascular and nerve injuries during the operation,and no complications such as loosening of internal fixation,rotation of fracture end and shortening and displacement after the operation.The average follow-up time was(9.47±3.15)months(6-12 months).The average cervical stem angle before surgery was 46.43°±10.38°,and the average cervical stem angle at the last follow-up was 15.58°±1.24°,the difference between preoperative and postoperative was statistically significant(P<0.01).At the last follow-up,according to the determination of total active activity of fingers(TAM),29 cases were excellent,11 cases were good,3 cases were fair,0 case was poor,and the excellent and good rate was 93%.Conclusion:Transverse support intramedullary fixation technique for the fifth metacarpal neck fracture has the advantages of simple operation,reliable fixation and accurate curative effect,and is a feasible minimally invasive treatment plan.

关 键 词：第五掌骨颈骨折 横行支撑固定 髓内固定技术 闭合复位 微创 

分 类 号：R683.41[医药卫生—骨科学]