Zemirline Ahmed, Lebailly Frédéric, Taleb Chihab, Facca Sybille, Liverneaux Philippe
Hand Surgery Department, Strasbourg University Hospitals, Illkirch, France.
Hand Surg. 2014;19(2):281-6. doi: 10.1142/S0218810414970053.
Several techniques are used for fixation of Bennett's fractures. The aim of this study was to assess a technique of arthroscopic-assisted reduction and percutaneous cannulated screw fixation of Bennett's fractures. Seven patients (mean age 29 years) with three fractures Type I and four fractures Type II according to Gedda were operated under arthroscopic lavage, fluoroscopic screw fixation, and arthroscopic control of the joint reduction. Arthroscopy, showed satisfactory joint reduction in all cases. At 4.5 months, the mean pain score was 1 (0-4), QuickDASH 15 (0-61), and Kapandji score 9 (5-10). Compared to the contralateral side, first web opening was 86% (58-100), key pinch 73% (45-89), grip strength, and 85% (40-100). Four secondary displacements were noted, two of which had a step of more than 1 mm. Our results showed that the use of arthroscopy for percutaneous screw fixation of Bennett's fractures facilitates joint reduction but does not guarantee stability of fixation.
有几种技术用于治疗班尼特骨折。本研究的目的是评估一种关节镜辅助复位和经皮空心螺钉固定班尼特骨折的技术。7例患者(平均年龄29岁),根据格德达分类,其中3例为I型骨折,4例为II型骨折,在关节镜冲洗、透视下螺钉固定以及关节复位的关节镜控制下进行手术。关节镜检查显示所有病例的关节复位均令人满意。在4.5个月时,平均疼痛评分为1分(0 - 4分),QuickDASH评分为15分(0 - 61分),卡潘迪评分为9分(5 - 10分)。与对侧相比,第一掌骨间隙张开度为86%(58 - 100),捏力为73%(45 - 89),握力为85%(40 - 100)。记录到4例继发移位,其中2例台阶超过1毫米。我们的结果表明,使用关节镜进行班尼特骨折的经皮螺钉固定有助于关节复位,但不能保证固定的稳定性。