Mader K, Gausepohl T, Pennig D
Abteilung für Unfallchirurgie, Hand- und Wiederherstellungschirurgie, St. Vinzenz-Hospital, Köln.
Handchir Mikrochir Plast Chir. 2000 Mar;32(2):107-11. doi: 10.1055/s-2000-19252.
Displaced perarticular fractures of the first metacarpal are mainly treated operatively due to the importance of the first ray for hand function. Open reduction and internal fixation as well as minimal-invasive techniques using minifixator systems may be employed. We use a minifixator, which allows pin-positioning even in small perarticular fragments eliminating the necessity of bridging joints. The anatomical basis, operative technique, and data of seven patients treated according to this method and results are presented. Range of motion according to the neutral-zero-method, tendon gliding, five-second-holding power, and force grip were equal compared to the uninjured contralateral side. The use of a minifixator to stabilize perarticular fractures of the first metacarpal includes the advantages of a minimal invasive procedure, respects the advantages of conservative fracture treatment, and permits secure fracture fixation after reduction.
由于第一掌骨对于手部功能的重要性,第一掌骨周围移位骨折主要采用手术治疗。可采用切开复位内固定以及使用微型固定器系统的微创技术。我们使用一种微型固定器,它即使在小的关节周围骨折块中也能进行钢针定位,从而无需跨关节固定。本文介绍了7例采用该方法治疗患者的解剖学基础、手术技术、数据及结果。与未受伤的对侧相比,根据中立位零位法测量的活动范围、肌腱滑动、五秒握力和强力握力均相同。使用微型固定器稳定第一掌骨周围骨折具有微创手术的优点,兼具保守骨折治疗的优势,且复位后能实现可靠的骨折固定。