Gao Shunhong, Feng Shiming, Jiao Cheng
No. 2 Department of Hand Surgery, the Second Hospital of Tangshan, Affiliated Orthopedic Hospital of Hebei United University, Tangshan Hebei, 063000, P.R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 Dec;26(12):1466-8.
To investigate the effectiveness of Kirschner wire combined with silk tension band in the treatment of ulnar collateral ligament avulsion fracture of the thumb metacarpophalangeal joint.
Between September 2008 and October 2011, 14 patients with ulnar collateral ligament avulsion fracture of the thumb metacarpophalangeal joint were treated using a combination of Kirschner wire and silk tension band. There were 8 males and 6 females, aged 23-55 years (mean, 40.8 years). The causes of injury were machinery twist injury in 5 cases, manual twist injury in 4 cases, falling in 4 cases, sports injury in 1 case. The time from injury to operation was 2 hours-14 days. All the patients presented pain over the ulnar aspect of the metacarpophalangeal joint of the thumb, limitation of motion, and joint instability with pinch and grip. The lateral stress testing of the metacarpophalangeal joint was positive. Function training was given at 2 weeks after operation.
All incisions healed by first intention. The lateral stress testing of the metacarpophalangeal joint was negative. All the patients were followed up 6-18 months (mean, 13.1 months). The X-ray films showed good fracture reduction and healing with an average time of 7 weeks (range, 4-10 weeks). At last follow-up, the thumbs had stable flexion and extension of the metacarpophalangeal joint, normal opposition function and grip and pinch strengths. According to Saetta et al. criteria for functional assessment, the results were excellent in 11 cases and good in 3 cases; the excellent and good rate was 100%.
It is an easy and simple method to treat ulnar collateral ligament avulsion fracture of the thumb metacarpophalangeal joint using Kirschner wire combined with silk tension band, which can meet the good finger function.
探讨克氏针联合丝线张力带治疗拇指掌指关节尺侧副韧带撕脱骨折的疗效。
2008年9月至2011年10月，采用克氏针联合丝线张力带治疗14例拇指掌指关节尺侧副韧带撕脱骨折患者。其中男性8例，女性6例，年龄23 - 55岁（平均40.8岁）。致伤原因：机器绞伤5例，手工拧伤4例，摔伤4例，运动损伤1例。受伤至手术时间为2小时至14天。所有患者均表现为拇指掌指关节尺侧疼痛、活动受限，捏物和握持时关节不稳定。掌指关节侧方应力试验阳性。术后2周进行功能训练。
所有切口均一期愈合。掌指关节侧方应力试验阴性。所有患者随访6 - 18个月（平均13.1个月）。X线片显示骨折复位及愈合良好，平均时间为7周（4 - 10周）。末次随访时，拇指掌指关节屈伸稳定，对掌功能正常，握力和捏力正常。根据Saetta等的功能评估标准，优11例，良3例；优良率为100%。
克氏针联合丝线张力带治疗拇指掌指关节尺侧副韧带撕脱骨折方法简便，能获得良好的手指功能。
