经皮克氏针髓内固定治疗掌、指骨骨折

目的评价经皮克氏针髓内固定技术在掌、指骨骨折中的治疗效果。方法对80例手部掌骨、近节指骨新鲜骨折,在手提式x光机监视下,采用手法整复经皮克氏针髓内固定术治疗。从患手的肌力,关节活动范围和影像学检查方面进行评价。结果术后平均随访5个月,术后X线片显示所有骨折均达到解剖复位或近解剖复位,平均4.2周拔除克氏针,除5例5处(均为近侧指间关节)手指伸直受限外,余均与健侧无明显差别,其患指握力与正常侧无明显差异,未出现针道感染。4处伴有近侧指间关节背侧皮肤软组织损伤,局部带蒂岛状皮瓣修复,其中2例伴有伸肌腱损伤一期修复。3例因局部皮肤及软组织挫伤严重,伤口延迟愈合,经换药后愈合。结论在有X线仪监视条件的医院经济条件比较差的新鲜掌指骨折患者,可采用闭合复位经皮克氏针髓内固定术,具有价格低廉,损伤小,固定确切,内固定取出方便,患者易接受等优点。

Objective evaluation on the effect of treatment of metacarpal and phalangeal fractures with intramedullary fixation of kirscbner＇ s pin. Methods 80 by the portable x-ray radiograph, via the manual reduction intramedullary fixation of kirschner＇ s pin. evaluated from the aspect of muscle force, rage of motion, and the image examination of the patients＇ band. Results followed for an average of 5 months, the x-ray showed anatomical or proximal reduction occurred in all the fractures, after an average of.4. 2 weeks, the k-wire was removed, except 4 patients 5 cases（ all are the proximal interphalangeal joint） limitation of finger flexion extension, others have no significant difference between the healthy side. the grip strength has no significant difference between the normal side, no experienced pin channel infection. 4 cases accompanied with damage of back skin and soft tissue of proximal interpha langeal joint, partieally existed repair of island flap of which 2 cases accompanied with extensor tendon injuries one-stage repair, only one case delayed wound healing for severe damage of partical skin and soft tissues,healed after dressing. Conclusion The poor patients of metacarpal and phalangeal fractures could adopt intramedullary fixation of kirschner＇ s pin for thrift economy, the technique possesses low price, less damage, precision fix, easily fetched for inner fixture, and facile accepted by patients.