改良闭合穿针治疗掌骨颈骨折

To treat the neck fracture of metacarpal by improved closed and Kirschner wires impalement

目的 探讨逆行闭合穿针治疗明显移位掌骨颈骨折的手术方法及临床疗效.方法 自2011年,应用逆行闭合穿针内固定法治疗掌骨颈骨折35例.术中经手法复位骨折后,采用2枚骨针沿掌骨头的两侧髁间窝向近端偏背侧交叉钻入固定掌骨颈,针尾留于掌骨头关节面下.结果 35例中治愈31例,好转3例,未愈1例.总有效率97.2％.术后随访2～12个月,骨折临床愈合时间8～12周,经指导锻炼3个月后功能恢复良好.结论 逆行闭合穿针内固定法治疗掌骨颈骨折,其疗效可靠,术后功能恢复良好,值得推广.

Objective To study the operation methods and chnical effects of closed reduction and impaled antidromic Kirschner wires to treat the obvious neck fracture of metacarpal. Methods After reduction of fracture, two Kirschner wires were vsed to fixed the metacarpal fracture by cross-drilling into the neck fracture along both sides of the intercondylar Fossa of metacarpal head to proximal partial dorsal bone. The tails of Kirschner wires were left under articular surface of metacarpus head. Results Among the 35 patients, 31 cases were cured, improved in 3 cases, 1 case did not heal. The total effective rate was 97.2%. Followed up for 2-12 months postoperatively, the time of fracture chnical healing was 8~12 weeks. Through guided exercise for 3 months, the function recovered well. Conclusion The methods of closed reduction and impaled antidromic Kirschner wires to treat the neck fracture of metacarpal is reliable. The postoperative function recovered well and is worthy to be popularized.