闭合复位经皮克氏针阻挡法治疗Bennett骨折疗效评估

Evaluation of the clinical efficacy of closed reduction and percutaneous Kirschner wire blocking in the treatment of Bennett′s fracture

目的介绍并评价闭合复位经皮克氏针阻挡法治疗Bennett骨折的方法和疗效。方法自2015年6月至2020年7月,我们应用闭合复位经皮克氏针阻挡法治疗Bennett骨折患者8例。术后随访摄X线片了解骨折愈合情况,调查患者是否回归正常工作或生活,测量第一腕掌关节屈伸、拇指内收外展活动度,及手部握力、拇示指捏力。采用Kapandji评分,视觉模拟评分(visual analogue scale,VAS)和DASH(the Disabilities of the Arm,Shoulder,and Hand questionnaire scores)评分评估手部疼痛和功能恢复情况。结果术后6例患者获得随访,时间为32~85个月,平均52.5个月,摄X线片显示所有患者骨折愈合,关节在位并回归正常工作或生活。第一腕掌关节屈伸活动度平均为62.2°,拇指内收外展活动度平均为56.8°,手部握力平均为33.4 kg,拇示指捏力平均为7.3 kg。Kapandji评分9.8,VAS为0.2,DASH评分0.98。结论闭合复位经皮克氏针阻挡法治疗Bennett骨折方法有效,值得临床应用。

Objective To introduce and evaluate the clinical efficacy of closed reduction and percutaneous Kirschner wire blocking in the treatment of Bennett′s fracture.Methods From June 2015 to July 2020,8 patients with Bennett′s fracture were treated by closed reduction and percutaneous Kirschner wire blocking method.The X-ray films were taken to understand the fracture healing status at postoperative follow-up,whether the patient has returned to normal work or life was investigated,the flexion and extension of the first carpometacarpal joint,thumb adduction and abduction range of motion,as well as hand grip strength and thumb index finger pinch strength were measured.The Kapandji score,visual analogue scale(VAS),and DASH(the Disabilities of the Arm,Shoulder,and Hand questionnaire scores)were used to evaluate hand pain and functional recovery.Results After surgery,6 patients were follow-up for a period of 32 to 85 months,with an average of 52.5 months.X-ray films showed that all patients had healed fractures,had joints in place,and returned to normal work or life.The average flexion and extension range of motion of the first carpometacarpal joint was 62.2°,the average adduction and abduction range of motion of the thumb was 56.8°,the average grip force of the hand was 33.4 kg,and the average pinch force of the thumb and index finger was 7.3 kg.The Kapandji scored 9.8,VAS was 0.2,and DASH was 0.98.Conclusion The closed reduction percutaneous Kirschner wire blocking method is effective in treating Bennett′s fracture and is worthy of clinical application.