Mehling I M, Schillo K, Arsalan-Werner A, Seegmüller J, Langheinrich A C, Sauerbier M
Abteilung für Plastische, Hand- und Rekonstruktive Chirurgie, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Friedberger Landstraße 430, 60389, Frankfurt/M, Deutschland.
Abteilung für Diagnostische und Interventionelle Radiologie, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Friedberger Landstraße 430, 60389, Frankfurt/M, Deutschland.
Unfallchirurg. 2016 Dec;119(12):978-985. doi: 10.1007/s00113-016-0233-x.
Fractures of the first thumb ray are common and need accurate differential treatment to restore gripping hand functions. Displaced fractures of the distal and proximal phalanx of the thumb are often treated with screws or Kirschner wires. Stable fractures can also be treated non-operatively. Fractures of the base of the first metacarpal should be differentiated into extra-articular Winterstein fractures and intra-articular Bennett or Rolando fractures. Traction forces by the abductor pollicis longus tendon regularly lead to displacement of the shaft of the first metacarpal; therefore, these fractures usually require reduction and fixation. Good functional results can be achieved by operative treatment. Fractures of the trapezium are rare. If they are displaced, operative treatment is recommended to prevent osteoarthritis of the first carpometacarpal joint.
拇指第一列骨折很常见,需要进行准确的鉴别治疗以恢复手部抓握功能。拇指远节和近节指骨的移位骨折通常采用螺钉或克氏针治疗。稳定型骨折也可采用非手术治疗。第一掌骨基底骨折应区分为关节外的温特施泰因骨折和关节内的贝内特或罗兰多骨折。拇长展肌腱的牵拉力常导致第一掌骨干移位;因此,这些骨折通常需要复位和固定。手术治疗可取得良好的功能效果。大多角骨骨折很少见。如果发生移位,建议手术治疗以预防第一腕掌关节骨关节炎。