邻近掌骨克氏针并联固定治疗掌骨粉碎性骨折

Parallel Kirschner wire fixation in adjacent comminuted metacarpal fractures

目的：探讨邻近掌骨克氏针并联固定治疗掌骨粉碎性骨折的效果。方法采用邻近掌骨克氏针并联固定治疗31例掌骨粉碎性骨折患者（40处）。结果31例患者均获随访,时间6∽12个月。27例伤口一期愈合,4例发生皮肤坏死,经清创局部皮瓣转移或冲洗引流植皮后创面愈合。31例骨折均愈合,其中1处骨折畸形愈合。按照手指总主动活动度（TAM）的评级标准并参考手指总主动屈曲度（TAF）的评级标准进行评定：优26例,良3例,中1例,差1例,优良率为93.5%。结论邻近掌骨克氏针并联固定是治疗掌骨粉碎性骨折的有效方法,早期功能锻炼对功能恢复至关重要。

Objective To investigate the effect of parallel Kirschner wire fixation of adjacent comminuted metacarpal fractures. Methods Adjacent metacarpal parallel Kirschner wire fixation was used in 31 patients with 40 comminu-ted metacarpal fractures. Results 31 cases were followed up for 6 ∽12 months. 27 cases got wound healing in one stage. 4 cases got skin necrosis and repaired with partial flap after debridement or skin grafting after washing drainage and got wound healing. 31 cases of fractures healed, including one malunion. According to the fingers of the total ac-tive activity （ TAM） rating criteria and reference finger total active flexion （ TAF） rating criteria to assess the effect, the results was excellent in 26 cases,good in 3,fair in 1,and poor in 1, the excellent and good rate was 93. 5%. Conclusions Parallel Kirschner wire fixation is effective for metacarpal fracture. Early exercise is essential for func-tional recovery.