Tan En Si, Tay Shian Chao
Department of Hand Surgery, Singapore General Hospital, Singapore.
Tech Hand Up Extrem Surg. 2016 Jun;20(2):77-82. doi: 10.1097/BTH.0000000000000119.
We propose a method for open reduction and internal fixation of early and unstable ulnar (fourth and/or fifth) carpometacarpal joint (CMCJ) fracture subluxations or dislocations using a dorsal buttress plate. In ulnar CMCJ fracture dislocations, the metacarpal has a tendency to displace dorsally and proximally when there is an axial load. Using the dorsal buttress plate method of fixation, a plate is fixed proximally to the hamate, aligned parallel and dorsal to the metacarpal to act as a buttress, to resist this movement. To preserve the fourth and the fifth CMCJ mobility, the distal end of the plate is not fixed to the metacarpal base. We illustrate the use of this technique on 4 patients who had different patterns of injury at the ulnar CMCJ. All patients regained excellent range of motion and function. None of the patients had redisplacement or nonunion of fracture. The dorsal buttress plate is a viable option for fixation of early and unstable ulnar CMCJ fracture subluxations or dislocations.
我们提出一种使用背侧支撑钢板对早期不稳定的尺侧（第四和/或第五）腕掌关节（CMCJ）骨折半脱位或脱位进行切开复位内固定的方法。在尺侧CMCJ骨折脱位中，当存在轴向负荷时，掌骨有向背侧和近端移位的倾向。采用背侧支撑钢板固定方法，将一块钢板近端固定于钩骨，与掌骨平行并位于其背侧作为支撑，以抵抗这种移位。为保留第四和第五CMCJ的活动度，钢板远端不固定于掌骨基部。我们举例说明了该技术在4例尺侧CMCJ损伤类型不同的患者中的应用。所有患者均恢复了极佳的活动范围和功能。无一例患者出现骨折再移位或不愈合。背侧支撑钢板是早期不稳定尺侧CMCJ骨折半脱位或脱位固定的一种可行选择。
