Calif E, Stahl S
Dept. of Orthopaedics A, Hand Surgery Unit, Rambam Medical Center, Rappaport Faculty of Medicine, Haifa.
Harefuah. 2001 Sep;140(9):813-5, 896.
Fractures of the base of the fifth metacarpal bone are relatively uncommon injuries. In contrast to similar fractures of the first metacarpal bone, various methods of treatment have been advocated. Some believe that cast immobilization or immediate unrestricted motion is a reliable method, while others recommend surgery and pinning or plate fixation. Fractures of the base of the fifth metacarpal bone are inherently unstable and inadequate reduction may result in pain, functional disability and osteoarthritic changes. We retrospectively reviewed 14 cases with intra-articular or extra-articular fractures of the base of the fifth metacarpal bone between the years 1991-1998. Patient treatment included closed reduction and percutaneous pinning using an image intensifier. Open reduction with multiple Kirschner pinning was implied in comminuted fractures and in cases when closed restoration of the articular surface was unfeasible. On follow-up examinations, all patients had good functional outcomes with no arthritic changes. We recommend reduction, restoration of the articular surface and pinning as the method of choice in the treatment of these fractures.
第五掌骨基底骨折是相对少见的损伤。与第一掌骨的类似骨折不同，人们提倡多种治疗方法。一些人认为石膏固定或立即进行无限制活动是可靠的方法，而另一些人则推荐手术及穿针或钢板固定。第五掌骨基底骨折本质上是不稳定的，复位不充分可能导致疼痛、功能障碍和骨关节炎改变。我们回顾性分析了1991年至1998年间14例第五掌骨基底关节内或关节外骨折的病例。患者的治疗包括使用影像增强器进行闭合复位和经皮穿针。粉碎性骨折以及关节面无法进行闭合复位的病例采用切开复位及多根克氏针固定。在随访检查中，所有患者功能恢复良好，未出现骨关节炎改变。我们推荐复位、恢复关节面及穿针作为治疗这些骨折的首选方法。
