跨关节钢板联合克氏针治疗第五腕掌关节骨折脱位的疗效分析

Clinical efficacy analysis of trans-articular plate combined with Kirschner wire for treatment of the fifth carpometacarpal joint fracture and dislocation

目的分析跨关节钢板联合克氏针治疗第五腕掌关节骨折脱位的疗效。方法自2016年7月至2018年6月,我们共收治10例第五腕掌关节骨折脱位患者,采用跨关节钢板联合克氏针法治疗。术后随访腕关节疼痛、活动范围、功能及握力等情况,使用Cooney腕关节功能评分法评估疗效。结果术后随访时间为10~33个月,平均20.3个月。术后未出现内固定断裂、骨不连及骨折畸形愈合等并发症。末次随访时患腕屈伸活动范围(116.2±11.9)°,为健侧的89.6%;患侧握力(85.2±19.6)lb,为健侧的91.1%;无疼痛7例、偶尔疼痛3例。所有患者均恢复正常工作。根据Cooney腕关节功能评分法进行功能评定:优2例,良8例。结论跨关节钢板联合克氏针法治疗第五腕掌关节骨折脱位疗效较为满意,值得临床应用。

Objective To evaluate the clinical efficacy of trans-articular plate combined with Kirschner wire for treatment of the fifth carpometacarpal joint fracture and dislocation.Methods From July 2016 to June 2018,10 cases of the fifth carpometacarpal joint fracture and dislocation were treated with trans-articular plate combined with Kirschner wire.The pain,range of motion,function and grip strength of the wrist were followed up after operation,and the effect was evaluated by Cooney wrist function score.Results The postoperative follow-up period ranged from 10 to 33 months,with an average of 20.3 months.There were no complications such as fracture of internal fixation,nonunion and malunion of fracture.At the last follow-up,the flexion and extension range of the affected wrist was(116.2±11.9)°which was 89.6%of that of the healthy side;the grip strength of the affected side was(85.2±19.6)lb which was 91.1%of that of the healthy side.There were 7 cases without pain and 3 cases with occasional pain.All patients returned to normal work.According to Cooney's wrist function score,2 cases were excellent and 8 cases were good.Conclusion The clinical efficacy of trans-articular plate combined with Kirschner wire for treatment of the fifth carpometacarpal joint fracture and dislocation is satisfactory and worthy of clinical application.