中国临床解剖学杂志 ›› 2021, Vol. 39 ›› Issue (1): 105-107.doi: 10.13418/j.issn.1001-165x.2021.01.020

• 临床研究 • 上一篇    下一篇

骨水泥封闭经皮克氏针外固定支架治疗第5掌骨颈骨折疗效

范辉, 陈代全, 张勤, 吴启龙, 施建兴, 高飞, 包其能, 伍维昌   

  1. 贵州盘江投资控股(集团)有限公司总医院骨四科,  贵州   盘州    553500
  • 收稿日期:2019-07-31 出版日期:2021-01-25 发布日期:2021-01-27
  • 作者简介:范辉(1980-),男,贵州六盘水人,副主任医师,主要从事骨科及手足显微外科修复重建研究, E-mail:28024402@qq.com

Curative effect of the percutaneous Kirschner wires external fixation combined with bone cements fixation in the treatment of the fifth metacarpal neck fracture

Fan Hui, Chen Daiquan, Zhang Qin, Wu Qilong, Shi Jianxing, Gao Fei, Bao Qineng, Wu Weichang    

  1. Department of Orthopaedics, Guizhou Panjiang Investment holding (Group) Corporation LTD.,Panzhou 553500,Guizhou Province, China
  • Received:2019-07-31 Online:2021-01-25 Published:2021-01-27

摘要: 目的 探讨应用骨水泥封闭经皮克氏针外固定支架治疗第5掌骨颈骨折的疗效。 方法 2017年6月~2019年1月,应用骨水泥封闭经皮克氏针外固定支架治疗第5掌骨颈骨折患者13例。其中男11例,女2例;年龄20~43岁,平均32.6岁。骨折原因:重物砸伤4例,摔伤4例,握拳锤击外物5例。受伤至手术时间3 h~5 d,平均9.8 h。根据骨折AO分型,B1型5例,B2型4例,B3型3例,C1型1例。  结果 所有患者骨折均获骨性愈合,愈合时间为9~13周,平均11.2周。骨折愈合后予以拆除外固定支架。其中1例患者术后10周意外再次受伤致外固定松动,查骨折愈合良好,即予拆除克氏针。随访6~14月,平均8.4月。末次随访时,掌指关节活动度与健侧掌指关节活动度对比无明显差异。第5掌骨头无塌陷畸形、小指无旋转畸形。  结论 采用骨水泥封闭经皮克氏针外固定支架治疗第5掌骨颈骨折,创伤小,操作简单,可早期活动掌指关节,疗效确切。

关键词: 掌骨,  骨折,  克氏针,  骨水泥,  手损伤

Abstract: Objective To investigate the curative effect of percutaneous Kirschner wires external fixation combined with bone cements fixation in the treatment of the fifth metacarpal neck fracture.  Methods From June 2017 to January 2019, patients with the fifth metacarpal neck fracture were treated with percutaneous Kirschner wires external fixation combined with bone cements, including 11 males and 2 females, with an average age of 32.6 years old (ranged 20-43 years). The causes of fracture were heavy pound injury in 4 cases, fall injury in 4 cases and clenched fist hammer in 5 cases. The time from injury to being operation was 3 hours less than 5 days, with an average of 9.8 hours. According to the AO classification of fractures, there were 5 cases of B1 type, 4 cases of B2 type, 3 cases of B3 type and 1 case of C1 type. Results All the patients were followed up for 6 to 14 months, with an average of 8.4 months. 1 patient was loosened with external fixation. Bone union was achieved in all the patients, and the healing time ranged from 9 to 13 weeks, with an average of 11.2 weeks. One of the patient was accidently injured again 10 weeks after the operation and the external fixation became loose. When the fracture healing examination was well, Kirschner wires was removed immediately. At the last follow-up, there was no significant difference in the range of motion between the metacarpophalangeal joint and the contralateral metacarpophalangeal joint. There was no collapse deformity of the fifth metacarpal bone and no rotation deformity of the little finger. Conclusions The treatment of the fifth metacarpal neck fracture with percutaneous Kirschner wires external fixation combined with bone cements fixation has the advantages of less trauma, simple operation and early movement of metacarpophalangeal joint, and the curative effect is definite.

Key words: Metacarpal bones,  Fracture,  Kirschner wires,  Bone cements,  Hand injuries

中图分类号: