Kiral Ahmet, Erken H Yener, Akmaz Ibrahim, Yildirim Cengiz, Erler Kaan
Department of Orthopaedic Surgery, Anadolu Medical Center, Kocaeli, Turkey; Department of Orthopaedic Surgery, GATA Haydarpaşa Education Hospital, Istanbul, Turkey.
Department of Orthopaedic Surgery, Anadolu Medical Center, Kocaeli, Turkey; Department of Orthopaedic Surgery, GATA Haydarpaşa Education Hospital, Istanbul, Turkey.
J Hand Surg Am. 2014 Apr;39(4):696-705. doi: 10.1016/j.jhsa.2013.12.038. Epub 2014 Feb 25.
To determine the efficacy of pins and rubber band traction for treatment of comminuted intra-articular fractures in the hand.
We performed a retrospective study from 1994 to 2013 to evaluate 33 patients in whom pins and rubber band traction was employed. We clinically evaluated the active range of motion of the affected fingers after surgery. Eleven of the 33 fractures were at the proximal interphalangeal joint, 10 at the distal interphalangeal joint, 5 at the thumb interphalangeal joint, and 2 at the metacarpophalangeal joint of the thumb. The remaining 5 patients had complex fracture-dislocation of the proximal interphalangeal joints.
The mean follow-up period was 24 months. The average active motion of the metacarpophalangeal joints of the fingers was 91° (range, extension 0°-10°/flexion 85°-90°), proximal interphalangeal joints was 92° (range, extension/flexion 0°-10°/85°-100°), and distal interphalangeal joints was 73° (range, extension/flexion 0°-10°/60°-80°). The overall average of all active motion of the injured fingers except thumbs was 255° (range, 240°-270°). The average active motion of the of the thumb metacarpophalangeal joint was 56° (range, extension 5°-10°/flexion 50°-55°), and interphalangeal joint was 74° (range, extension 0°-10°/flexion 75°-80°). The average of active motion of the injured thumb metacarpal and interphalangeal joints combined was 130° (range, 125°-135°).
Pins and rubber band traction is a treatment option for comminuted displaced intra-articular fractures of the digits that offers satisfactory clinical results.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
确定克氏针和橡皮筋牵引治疗手部关节内粉碎性骨折的疗效。
我们进行了一项回顾性研究，研究时间为1994年至2013年，评估了33例采用克氏针和橡皮筋牵引治疗的患者。我们临床评估了术后患指的主动活动范围。33例骨折中，11例位于近端指间关节，10例位于远端指间关节，5例位于拇指指间关节，2例位于拇指掌指关节。其余5例患者为近端指间关节复杂骨折脱位。
平均随访期为24个月。手指掌指关节的平均主动活动度为91°（范围，伸展0°-10°/屈曲85°-90°），近端指间关节为92°（范围，伸展/屈曲0°-10°/85°-100°），远端指间关节为73°（范围，伸展/屈曲0°-10°/60°-80°）。除拇指外，受伤手指所有主动活动的总体平均值为255°（范围，240°-270°）。拇指掌指关节的平均主动活动度为56°（范围，伸展5°-10°/屈曲50°-55°），指间关节为74°（范围，伸展0°-10°/屈曲75°-80°）。受伤拇指掌骨和指间关节主动活动度的平均值为130°（范围，125°-135°）。
克氏针和橡皮筋牵引是治疗手指关节内粉碎性移位骨折的一种治疗选择，临床效果满意。
研究类型/证据水平：治疗性IV级。
