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[四种不同固定方法在第五掌骨颈骨折保守治疗中的疗效]

[Outcomes of four distinct fixation methods in the conservative treatment of fifth metacarpal neck fractures].

作者信息

Kiliç Ayhan, Sökücü Sami, Basilgan Seçkin, Yeniocak Sedat, Cetinkaya Engin, Parmaksizoğlu Atilla Sancar, Kabukcuoğlu Yavuz Selim

机构信息

Taksim Eğitim ve Araştirma Hastanesi Ortopedi ve Travmayoloji Kliniği, Istanbul, Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2012 Mar;18(2):167-70. doi: 10.5505/tjtes.2012.23090.

Abstract

BACKGROUND

We evaluated four distinct fixation methods for the conservative treatment of neck fractures of the fifth metacarpal.

METHODS

Patients in our clinics who were treated with non-surgical methods following closed reduction between 2008 and 2009 were evaluated prospectively. In this study consisting of 60 male patients, the following fixation methods were applied for four weeks: circular cast extending from the wrist to the distal interphalangeal (DIP) joint (Group A), circular cast covering semiflexed metacarpophalangeal (MCP) and DIP from the wrist to the DIP joint (Group B), circular self-adherent wrap covering metacarpal bones II-V, from the wrist to the DIP joint (Group C), and ulnar gutter splint covering semi-flexed IV-V MCP, proximal (PIP) and DIP joints (Group D). In patients who were followed up with anteroposterior (AP) and oblique radiography, angulations and metacarpal lengths were measured before and after reduction.

RESULTS

Fifty-two patients with an average age of 30 (SD: 9) years completed the study. For fractures with radiographic angulation of 17 degrees (SD: 11) and 46 degrees (SD: 11.7) before treatment, union was achieved with an angulation of 5 degrees (SD: 5.9) and 27 degrees (SD: 10.5) after four weeks (p: 0.05).

CONCLUSION

No statistically significant difference was found between the non-surgical methods applied for treatment of fifth metacarpal fractures.

摘要

背景

我们评估了四种不同的固定方法用于第五掌骨颈部骨折的保守治疗。

方法

对2008年至2009年间在我们诊所接受闭合复位后非手术治疗的患者进行前瞻性评估。在这项由60名男性患者组成的研究中,以下固定方法应用四周:从腕部延伸至远侧指间关节(DIP)的环形石膏(A组),从腕部至DIP关节覆盖半屈曲掌指关节(MCP)和DIP的环形石膏(B组),从腕部至DIP关节覆盖第II-V掌骨的环形自粘绷带(C组),以及覆盖半屈曲第IV-V掌指关节、近端指间关节(PIP)和DIP关节的尺侧沟夹板(D组)。对接受前后位(AP)和斜位X线摄影随访的患者,在复位前后测量成角和掌骨长度。

结果

52例平均年龄30岁(标准差:9岁)的患者完成了研究。对于治疗前X线成角分别为17度(标准差:11度)和46度(标准差:11.7度)的骨折,四周后成角分别为5度(标准差:5.9度)和27度(标准差:10.5度)时实现了愈合(p值:0.05)。

结论

用于治疗第五掌骨骨折的非手术方法之间未发现统计学上的显著差异。

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