Trabelsi A, Dusserre F, Asencio G, Bertin R
Service de chirurgie orthopédique et traumatologique, CHU Gaston Doumergue, 5, rue hoche, 30000 Nîmes, France.
Chir Main. 2001 Jun;20(3):226-30. doi: 10.1016/s1297-3203(01)00038-5.
Many methods of treatment have been proposed for the metacarpal neck fractures of the little finger, from early mobilisation to open or closed surgical techniques. A prospective studies of 20 cases treated by a non surgical technique is presented. The reduction was performed by manipulation under local anesthesia according to the Jahss technique and a modified Thomine brace was applied for four weeks. All patients were reviewed for follow-up at 30, 60, and 180 days. The fracture displacement was initially 34 degrees. It was reduced by manipulation to 12 degrees. All fractures healed with an average final displacement of 20 degrees. At 6 months for final examination, average T.A.M. was 245 degrees, T.P.M. was 276 degrees, grip strength reached 96% of the other hand. There were 19 excellent and one bad results. In conclusion, ambulatory non surgical treatment by reduction and local immobilisation of the fractures of the fifth metacarpal provide a good final result with a low cost.
对于小指掌骨颈骨折,已经提出了许多治疗方法,从早期活动到开放或闭合手术技术。本文介绍了一项对20例采用非手术技术治疗的前瞻性研究。根据Jahss技术在局部麻醉下进行手法复位,并应用改良的Thomine支具固定四周。所有患者在30天、60天和180天进行随访复查。骨折移位最初为34度,经手法复位后降至12度。所有骨折均愈合,最终平均移位为20度。在6个月的最终检查中,平均总主动活动度(T.A.M.)为245度,总被动活动度(T.P.M.)为276度,握力达到对侧手的96%。结果19例优,1例差。总之,通过手法复位和局部固定对第五掌骨骨折进行非手术门诊治疗,最终效果良好且成本低。