Galanakis Ioannis, Aligizakis Agisilaos, Katonis Pavlos, Papadokostakis Giorgos, Stergiopoulos Kostantinos, Hadjipavlou Alexandros
Department of Orthopaedics, University of Crete, Greece.
J Trauma. 2003 Sep;55(3):509-13. doi: 10.1097/01.TA.0000029368.40479.A2.
The vast majority of metacarpal bone fractures are stable and are treated conservatively; however, when surgical intervention is to be preferred, many different operative procedures have been described. The purpose of this prospective study was to assess the anatomic and functional outcome of percutaneous transverse fixation with Kirschner wires (K-wires) of closed metacarpal neck, shaft. and intra-articular fractures of the base of the fifth metacarpal.
Twenty-four consecutive patients with 25 closed metacarpal fractures were treated with this technique between 1999 and 2001. Under fluoroscopy, closed reduction and osteosynthesis with three K-wires, one proximally and two distally, was performed on the fracture site. All patients were reviewed clinically and radiologically after 3 weeks, 6 weeks, and 3 months.
The postoperative dorsal angulation ranged from 0 to 3 degrees. No measurable metacarpal shortening was observed. Callus formation was obvious in all fractures at 6 weeks. No complications were recorded, and all patients were cosmetically and functionally satisfied.
Treatment of closed metacarpal neck, shaft, and intra-articular fractures of the base of the fifth metacarpal with percutaneous transverse pinning, using two K-wires distally and one proximally, has shown excellent functional and anatomic outcome.
绝大多数掌骨骨折是稳定的，采用保守治疗；然而，当首选手术干预时，已有多种不同的手术方法被描述。本前瞻性研究的目的是评估经皮克氏针横向固定治疗第五掌骨闭合性掌骨颈、骨干和关节内基底骨折的解剖学和功能结果。
1999年至2001年间，连续24例患者的25处闭合性掌骨骨折采用该技术治疗。在透视下，对骨折部位进行闭合复位并用三根克氏针进行内固定，一根在近端，两根在远端。所有患者在术后3周、6周和3个月时进行临床和影像学复查。
术后背侧成角范围为0至3度。未观察到可测量的掌骨缩短。6周时所有骨折处均可见明显骨痂形成。未记录到并发症，所有患者在外观和功能上均满意。
采用两根克氏针在远端、一根在近端的经皮横向穿针固定治疗第五掌骨闭合性掌骨颈、骨干和关节内基底骨折，已显示出优异的功能和解剖学结果。
