闭合复位掌骨间克氏针固定治疗第一掌骨基底部骨折_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

肖聪 ,  蒋涛 , 徐建华 , 钟易林 , 孙天祥 , 姜义山 , 唐仁德 , 陈银华

绵阳市第三人民医院骨科（四川绵阳，621000）;

Corresponding author：

蒋涛, Email: joggingman@163.com

Keywords：

第1掌骨基底部骨折; 闭合复位; 克氏针; 经皮固定

DOI：

10.7507/1002-1892.20140056

Video：

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目的总结闭合复位第1、2掌骨间克氏针固定治疗第1掌骨基底部骨折的临床疗效。方法 2009年4月－2012年3月，采用闭合复位第1、2掌骨间克氏针固定治疗第1掌骨基底部骨折患者29例。男22例，女7例；年龄25～51岁，平均30.5岁。伤后至手术时间1 h～3 d，平均9.6 h。骨折根据Green-O’Brien分型：Ⅰ型13例，Ⅱ型5 例，ⅢA型9例，ⅢB型2例。采用疼痛视觉模拟评分（VAS）评估拇指关节疼痛情况；测量第1腕掌关节屈伸活动度（range of motion，ROM）、拇指外展ROM及握力，分别与健侧比较；末次随访时摄X线片根据改良Eaton-Littler分期标准评估骨关节炎表现。结果患者均获随访，随访时间12～16个月，平均13.2个月。其中3例发生针道感染，2例发生克氏针松动。患者骨折均获骨性愈合，愈合时间为3～4个月，平均3.3个月。末次随访时VAS评分为（0.48±0.06）分。第1腕掌关节屈伸ROM、拇指外展ROM及握力与健侧比较，差异均无统计学意义（P＞0.05）。第1腕掌关节骨关节炎表现：Ⅰ期15例，Ⅱ期6例，Ⅲ期8例。结论闭合复位第1、2掌骨间克氏针固定操作简便、损伤小、疗效确切，是治疗第1掌骨间基底部骨折的有效方法。

Citation： 肖聪, 蒋涛, 徐建华, 钟易林, 孙天祥, 姜义山, 唐仁德, 陈银华. 闭合复位掌骨间克氏针固定治疗第一掌骨基底部骨折. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(2): 259-260. doi: 10.7507/1002-1892.20140056 Copy

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1. van Niekerk JL,Ouwens R.Fractures of the base of the first metacarpal bone:results of surgical treatment.Injury,1989,20(6):359-362.
2. Greeven AP,Alta TD,Scholtens RE,et al.Closed reduction intermetacarpal Kirschner wire fixation in the treatment of unstable fractures of the base of the first metacarpal.Injury,2012,43(2):246-251.
3. 李智富,许扬滨.第一掌骨基底骨折的治疗进展.实用手外科杂志,2005,19(3):160-162.
4. Leclère FM,Jenzer A,Hüsler R,et al.7-year follow-up after open reduction and internal screw fixation in Bennett fractures.Arch Orthop Trauma Surg,2012,132(7):1045-1051.
5. Kontakis GM,Katonis PG,Steriopoulos KA.Rolando's fracture treated by closed reduction and external fixation.Arch Orthop Trauma Surg,1998,117(1-2):84-85.
6. Timmenga EJ,Blokhuis TJ,Maas M,et al.Long-term evaluation of Bennett's fracture.A comparison between open and closed reduction.J Hand Surg (Br),1994,19(3):373-377.

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Chinese Journal of Reparative and Reconstructive Surgery

闭合复位掌骨间克氏针固定治疗第一掌骨基底部骨折

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