Westbrook A P, Davis T R C, Armstrong D, Burke F D
Department of Trauma and Orthopaedic Surgery, Queen's Medical Campus, Nottingham University Hospitals, Nottingham, UK.
J Hand Surg Eur Vol. 2008 Dec;33(6):732-9. doi: 10.1177/1753193408092497. Epub 2008 Oct 20.
The outcomes of 218 little finger metacarpal shaft and neck fractures that had been treated non-operatively, with no attempt at fracture reduction, were compared with those of 44 that had been treated operatively with fracture reduction and fixation (plates or K-wires). Outcome measures included the grip strength of the little finger and the DASH score. Fracture malunion was assessed by clinical measurement of little finger ray shortening and measurement of palmar angulation on the initial radiographs. The severity of palmar angular deformity did not affect the outcome of the 105 metacarpal neck or 113 metacarpal shaft fractures that had been treated non-operatively. There were no differences between the outcomes of the 18 metacarpal neck fractures treated operatively and the 105 treated non-operatively. The DASH score (P = 0.001) and aesthetic outcome (P = 0.013) were significantly better for the 113 metacarpal shaft fractures treated non-operatively than for the 26 treated operatively.
对218例未进行手术复位、仅采取非手术治疗的小指掌骨干和掌骨颈骨折的治疗结果，与44例进行了骨折复位及固定（钢板或克氏针）的手术治疗的病例进行了比较。疗效评估指标包括小指握力和DASH评分。通过临床测量小指射线缩短情况以及测量初始X线片上的掌侧成角来评估骨折畸形愈合情况。掌侧角状畸形的严重程度并不影响105例接受非手术治疗的掌骨颈骨折或113例掌骨干骨折的治疗结果。18例接受手术治疗的掌骨颈骨折与105例接受非手术治疗的病例在治疗结果上并无差异。113例接受非手术治疗的掌骨干骨折的DASH评分（P = 0.001）和美学效果（P = 0.013）显著优于26例接受手术治疗的病例。
