单克氏针顺行髓内固定微创治疗第五掌骨颈移位骨折的疗效观察

doi:10.3760/cam.j.cn101202-20231228-00193

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摘要目的探讨单克氏针顺行髓内固定微创治疗第五掌骨颈移位骨折的临床效果。方法病例系统报告。纳入2018年2月—2022年6月云南省第一人民医院骨科采用单克氏针尾部折弯顺行髓内固定微创治疗的18例第五掌骨颈移位骨折患者资料。其中男14例、女4例,年龄18~45岁（28.4±7.3）。术后石膏固定2周后行功能锻炼,术后8~10周X线检查显示骨折愈合后拔除克氏针。记录手术时间、术中X线透视次数;手术前及手术后第1天复查X线片,测量并比较手术前后第五掌骨头干角;术后随访期间观察骨折愈合及并发症情况,采用总主动活动度（TAM）评定并记录末次随访时手部功能。结果 18例患者手术均顺利完成,手术时间15~35（22.6±5.2）min,术中X线透视次数2~7（3.9±1.2）次。第五掌骨头干角术前为51.28°±5.71°,术后为18.72°±2.05°,差异有统计学意义（t=22.78,P<0.001）。18例患者术后随访7~20（13.8±3.6）个月,骨折均于8~10周愈合。末次随访患者手部功能TAM评定为优15例、良2例、可1例,优良率17/18。术后克氏针针尾触痛1例,取出克氏针后症状消失;尺神经背侧皮支区域暂时性感觉异常1例。结论采用单克氏针顺行髓内固定微创治疗第五掌骨颈移位骨折临床效果佳,且手术操作简单、时间短,并发症少。

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	董凯旋
	兰宗林
	程耀宇
	罗浩天
	杨曦
	赵晓芳
	陆声

关键词 ：骨折, 闭合性, 掌骨, 第五掌骨颈骨折, 骨折固定术, 髓内, 克氏针, 微创手术

Key words： Fractures closed Metacarpal bones Fracture of the fifth metacarpal neck Fracture fixation intramedullary Kirschner wire Microtraumatic operation

收稿日期: 2023-12-28

基金资助:云南省科技厅科技人才与平台计划（202005AG070004）; 云南省科技厅重大科技专项计划（202102AA310068）; 昆明医科大学基础研究联合专项计划（202301AY070001-051）

通讯作者: 陆声,Email：drlusheng@163.com

引用本文:

董凯旋, 兰宗林, 程耀宇, 罗浩天, 杨曦, 赵晓芳, 陆声. 单克氏针顺行髓内固定微创治疗第五掌骨颈移位骨折的疗效观察[J]. 中华解剖与临床杂志, 2024, 29(4): 269-273.
Dong Kaixuan, Lan Zonglin, Cheng Yaoyu, Luo Haotian, Yang Xi, Zhao Xiaofang, Lu Sheng. Observation on the effect of single Kirschner wire antegrade intramedullary fixation for minimally invasive treatment of displaced fracture of the fifth metacarpal neck. Chinese Journal of Anatomy and Clinics, 2024, 29(4): 269-273.

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http://www.cjac.com.cn/CN/10.3760/cam.j.cn101202-20231228-00193 或 http://www.cjac.com.cn/CN/Y2024/V29/I4/269

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