MODIFIED INTRAMEDULLARY FIXATION WITH TWO Kirschner WIRES FOR EXTRA-ARTICULAR FRACTURE OF PROXIMAL PHALANGEAL BASE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIShengzhou ¹ ,  WUKewan ¹ , XIELu ¹ , CHENLin ²

1. Department of Emergency Surgery, Yinzhou No. 2 Hospital, Ningbo Zhejiang, 315100, P. R. China;
2. Department of Hand Surgery, Huashan Hospital, Fudan University;

Corresponding author：

WUKewan, Email: wkw1976@sina.com

Keywords：

Phalanx; Basal fracture; Intramedullary fixation; Kirschner wire

DOI：

10.7507/1002-1892.20160189

Video：

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Objective To evaluate the effectiveness of the modified intramedullary fixation with two Kirschner wires for extra-articular fracture of the proximal phalangeal base. Methods Between June 2012 and November 2015, 18 cases (18 fingers) of fresh extra-articular fracture of the proximal phalangeal base were treated, including 16 males and 2 females with an average age of 31 years (range, 21-57 years). The causes included strike injury in 10 cases, fall injury in 4 cases, mechanical injury in 1 case, twist injury in 1 case, crush injury in 1 case, and cutting injury in 1 case. The injured fingers were little finger in 16 cases, ring finger in 1 case, and index finger in 1 case. Of the 18 cases, 17 had closed fractures and 1 had open fracture. X-ray film showed transverse fracture in 14 cases and transverse-oblique fracture in 4 cases. The time between injury and operation was 3 hours to 4 days (mean, 2 days). After anatomical reduction, two Kirschner wires were used for intramedullary fixation. Functional exercises were done at 2 days after operation. The Kirschner wires were removed at 4 weeks after operation. Results All the wounds healed by first intention. There were no deformation, loosening or breakage of Kirschner wires, and pin tract infection. Postoperative X-ray films showed anatomical reduction of fracture in all cases; no re-displacement happened, and clinical healing was obtained at 4 weeks; bony union was obtained at 8 weeks. All patients were followed up 6-12 months with an average of 8 months. There was no pain in the metacarpophalangeal joint; the range of motion was (88.1±2.3)° at 3 months after operation, showing no significant difference when compared with normal side [(88.8±2.6)°] (t=1.73, P=0.10). The finger flexion and extension were normal; according to the criteria of total active motion of finger, the results were excellent in all cases. Conclusion The technique of modified intramedullary fixation with two Kirschner wires for extra-articular fractures of the proximal phalangeal base has the merits of convenient operation, little injury, reliable fixation, and excellent effectiveness. This technique is conducive to the recovery of hand function due to the early functional exercises.

Citation： LIShengzhou, WUKewan, XIELu, CHENLin. MODIFIED INTRAMEDULLARY FIXATION WITH TWO Kirschner WIRES FOR EXTRA-ARTICULAR FRACTURE OF PROXIMAL PHALANGEAL BASE. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(8): 935-938. doi: 10.7507/1002-1892.20160189 Copy

1.	刘亮, 吕云亮, 魏勇, 等.闭合整复AO克氏针固定治疗非粉碎性指骨骨折.中华手外科杂志, 2014, 30(2):151-152.
2.	田德虎, 白江博, 张英泽, 等.微型钢板治疗掌指骨骨折的疗效分析.中国修复重建外科杂志, 2009, 23(1):119-120.
3.	黄俊伍, 罗轶.指骨背侧与侧方放置微型钢板治疗近节指骨骨折的临床对比研究.中华手外科杂志, 2012, 28(3):157-159.
4.	白印伟, 张振伟, 庄加川, 等. AO微型钛板在近节指骨骨折中的应用.中华手外科杂志, 2010, 26(4):252.
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8.	于家傲, 路来金, 刘志刚, 等.闭合内固定术治疗手部掌指骨骨折的临床研究.中华手外科杂志, 2003, 19(2):77-79.
9.	宋宏亮, 龚维明, 宁斌, 等.经掌指关节闭合穿钉内固定治疗近节指骨骨折.山东医药, 2009, 49(12):20.
10.	顾玉东.如何治疗手部骨折--评AO微型钢板的应用价值.中华手外科杂志, 2002, 18(2):65.
11.	张全荣, 李向荣, 芮永军, 等.不经关节的内固定治疗掌指骨骨折.中华手外科杂志, 1995, 11(3):191-192.
12.	Xu J, Zhang C. Mini-plate versus Kirschner wire internal fixation for treatment of metacarpal and phalangeal fractures in Chinese Han population:a meta-analysis. J Orthop Surg Res, 2014, 9:24.
13.	刘爱波. AO微型钢板与克氏针内固定治疗手部关节内骨折的疗效对比分析.中华手外科杂志, 2015, 31(2):145-146.
14.	Ruedi TP, Mushy WM.骨折治疗的AO原则.王满宜, 杨庆铭, 曾炳芳, 等译.北京:华夏出版社, 2003:379-387.
15.	常刚, 许有, 闫乔生, 等.掌指骨骨折治疗的临床研究.中华手外科杂志, 2011, 27(4):251-252.
16.	王强, 张文辉, 熊革.微型钛板掌侧固定治疗手指近节指骨骨折.中华手外科杂志, 2011, 27(5):313-314.

1. 刘亮, 吕云亮, 魏勇, 等.闭合整复AO克氏针固定治疗非粉碎性指骨骨折.中华手外科杂志, 2014, 30(2):151-152.
2. 田德虎, 白江博, 张英泽, 等.微型钢板治疗掌指骨骨折的疗效分析.中国修复重建外科杂志, 2009, 23(1):119-120.
3. 黄俊伍, 罗轶.指骨背侧与侧方放置微型钢板治疗近节指骨骨折的临床对比研究.中华手外科杂志, 2012, 28(3):157-159.
4. 白印伟, 张振伟, 庄加川, 等. AO微型钛板在近节指骨骨折中的应用.中华手外科杂志, 2010, 26(4):252.
5. 马鑫, 孙鲁源, 代杰志, 等.微型外固定架治疗掌指骨开放性粉碎骨折.中国修复重建外科杂志, 2013, 27(1):17-20.
6. 田建, 芮永军, 糜菁熠, 等.微型外固定支架结合有限内固定治疗开放性粉碎性掌指骨骨折.中华手外科杂志, 2013, 29(1):4-6.
7. 王澍寰.手外科学.北京:人民卫生出版社, 1999:257-275, 466.
8. 于家傲, 路来金, 刘志刚, 等.闭合内固定术治疗手部掌指骨骨折的临床研究.中华手外科杂志, 2003, 19(2):77-79.
9. 宋宏亮, 龚维明, 宁斌, 等.经掌指关节闭合穿钉内固定治疗近节指骨骨折.山东医药, 2009, 49(12):20.
10. 顾玉东.如何治疗手部骨折--评AO微型钢板的应用价值.中华手外科杂志, 2002, 18(2):65.
11. 张全荣, 李向荣, 芮永军, 等.不经关节的内固定治疗掌指骨骨折.中华手外科杂志, 1995, 11(3):191-192.
12. Xu J, Zhang C. Mini-plate versus Kirschner wire internal fixation for treatment of metacarpal and phalangeal fractures in Chinese Han population:a meta-analysis. J Orthop Surg Res, 2014, 9:24.
13. 刘爱波. AO微型钢板与克氏针内固定治疗手部关节内骨折的疗效对比分析.中华手外科杂志, 2015, 31(2):145-146.
14. Ruedi TP, Mushy WM.骨折治疗的AO原则.王满宜, 杨庆铭, 曾炳芳, 等译.北京:华夏出版社, 2003:379-387.
15. 常刚, 许有, 闫乔生, 等.掌指骨骨折治疗的临床研究.中华手外科杂志, 2011, 27(4):251-252.
16. 王强, 张文辉, 熊革.微型钛板掌侧固定治疗手指近节指骨骨折.中华手外科杂志, 2011, 27(5):313-314.

Chinese Journal of Reparative and Reconstructive Surgery

MODIFIED INTRAMEDULLARY FIXATION WITH TWO Kirschner WIRES FOR EXTRA-ARTICULAR FRACTURE OF PROXIMAL PHALANGEAL BASE

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