Bennett骨折闭合整复透视下克氏针内固定术的临床观察

Clinical observation on Kirschner pins internal fixation under fluoroscopic closed reduction for treating Bennett′ s fracture

目的:探讨闭合手法复位后透视下经皮克氏针内固定术治疗Bennett骨折的可行性,评价其对骨折修复的作用及后期功能恢复情况。方法:对12例Bennett骨折患者在X线透视下两助手牵引复位,用2枚克氏针固定大多角骨及第一、二掌骨,维持骨折块的解剖复位,观察疗效。结果:术中骨折均解剖复位,石膏外固定4～6周后去除内固定,12例患者随访9个月,骨折无错位,一期愈合,露在皮外克氏针未发生感染,拇指腕掌关节功能良好。结论:闭合整复透视下2枚克氏针内固定术治疗Bennett骨折固定可靠,疗效确切,能减轻患者痛苦及经济负担,适于基层医院推广应用。

Objective：To study the feasibility of fluoroscopic transpercutaneous two Kirschner pins internal fixation after manipulative closed reduction for treating Bennett′ s fracture and to evaluate its effects on fracture repair and the function recovery status in later stage.Methods：12 cases of Bennett′ s fracture were performed the traction reduction with two kirschner pins by two assistants under X-ray fluoroscopy and the trapezium bone,first and second metacarpal bones were fixed by 2 Kirschner pins for maintaining the anatomical reduction of fracture blocks.The curative effects were observed.Results：Fractures all were anatomically reattached during operation.The internal fixation was removed after 4-6 weeks of gesso external fixation.12 cases were followed up for 9 months without fracture dislocation,showing primary healing,non-infection in Kirschner pins in skin outside and good function of carpometacarpal joint of thumb.Conclusion：Two Kirschner pins internal fixation under fluoroscopic closed reduction for treating Bennett′ s fracture is reliable with definite effects,relieving patient′s pain and reducing patient′ s economic burden,which is suitable for application of basic-level hospitals.