Ali Hyder, Rafique Atif, Bhatti Mabroor, Ghani Shahab, Sadiq Moiz, Beg Shehab Afzal
Liaquat National Hospital, Karachi.
J Pak Med Assoc. 2007 Feb;57(2):64-7.
To assess the type of fractures of metacarpal and phalanges of hand and their treatment plan, investigate the risk factors (infection, segmental bone loss, associated soft tissue injuries) for the development of delayed union of the fracture site.
This descriptive study was conducted at Plastic, Reconstructive and Hand Surgery Unit, Liaquat National Hospital, Karachi. It included 120 patients who attended Accident and Emergency Department with metacarpals and phalanges fractures during August 2005 to January 2006. Severely traumatized patients or patients with amputated hand or digits were excluded. The data was collected through hand injury chart which fulfilled the inclusion criteria. Data was analyzed by SPSS version-10.
In 120 patients with 226 fractures of the metacarpals and phalanges male to female ratio was 5:1. Metacarpal fractures were 38.9% and the fracture of the phalanges was 61.1%. Oblique fractures were 47%, transverse 28.3%, comminuted 13.27%, spiral 8.9%, and avulsion fractures were 2.6%. Surgically treated patients were 78.3% while 21.7% were managed conservatively. For fixation of fractures Kirschner wires (K-wire) were used in 89.36% cases, miniplates and lag screw in 4.25% and external fixators in 2.1%. Infection was found in 5 (2.2%) of the total fractures, out of these 2/5 (40%) had developed non union of the fracture site. Bony defect was found in 30 (13.3%) of the total fractures, of these 4/30 (13.3%) developed non union. Associated soft tissue injury was found in 130 (57.5%) and of these 11/130 (8.46%) developed non union.
Most of the fractures of the metacarpals and phalanges were oblique in configuration, followed by transverse fractures. More then 75% of these fractures where treated surgically. K-wiring was the most commonly performed procedure. Infection, segmental bone loss and associated soft tissue injuries were predisposed to non union in small percentage of cases.
评估手部掌骨和指骨骨折的类型及其治疗方案，调查骨折部位延迟愈合发生的危险因素（感染、节段性骨缺损、相关软组织损伤）。
本描述性研究在卡拉奇利亚卡特国家医院整形、重建和手部外科进行。研究纳入了2005年8月至2006年1月期间因掌骨和指骨骨折就诊于急诊科的120例患者。排除严重创伤患者或手部或手指截肢患者。通过符合纳入标准的手部损伤图表收集数据。数据采用SPSS 10版进行分析。
120例患者共226处掌骨和指骨骨折，男女比例为5∶1。掌骨骨折占38.9%，指骨骨折占61.1%。斜形骨折占47%，横行骨折占28.3%，粉碎性骨折占13.27%，螺旋形骨折占8.9%，撕脱性骨折占2.6%。手术治疗患者占78.3%，保守治疗患者占21.7%。骨折固定中，89.36%的病例使用克氏针（K针），4.25%使用微型钢板和拉力螺钉，2.1%使用外固定架。全部骨折中5处（2.2%）发生感染，其中2/5（40%）骨折部位出现骨不连。全部骨折中30处（13.3%）发现骨缺损，其中4/30（13.3%）出现骨不连。130处（57.5%）发现相关软组织损伤，其中11/130（8.46%）出现骨不连。
大多数掌骨和指骨骨折为斜形，其次为横行骨折。这些骨折中超过75%接受手术治疗。克氏针内固定是最常用的手术方式。感染、节段性骨缺损和相关软组织损伤在少数病例中易导致骨不连。
