Pogliacomi Francesco, Mijno Elisabetta, Pedrazzini Alesssio, Tocco Silvio, Tonani Massimo, Ceccarelli Francesco, Vaienti Enrico
PARMA UNIVERSITY DEPARTMENT OF MEDICINE AND SURGERY ORTHOPAEDIC AND TRAUMATOLOGY SECTION.
Acta Biomed. 2017 Apr 28;88(1):57-64. doi: 10.23750/abm.v88i1.6195.
Fifth metacarpal neck fractures (commonly named "boxer's fractures") are the most common metacarpal injuries and usually affect young active people. These lesions are mainly treated conservatively. Their surgical management, if indicated, is still a matter of debate. Different procedures have been described. The aim of this study was to evaluate the outcomes of 18 boxer's fractures which were synthesized with antegrade locked flexible intramedullary nailing.
All patients, at a mean follow-up of 45 months, were clinically evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) score and the Patient Rated Wrist/Hand Evaluation (PRWHE). Active and passive range of motion (ROM) of metacarpo-phalangeal (MP), proximal and distal interphalangeal (PIP and DIP) joints and Total Active Motion (TAM), and grip strength were also analyzed. Apex dorsal angulation and axial shortening were radiologically measured preoperatively and at final follow-up.
Clinical and radiological results which were observed were satisfactory. No TAM and grip strength differences were recorded between the operated and healthy contralateral hand.
According to the positive outcomes and the low rate of complications of this study, antegrade locked flexible intramedullary nailing can be considered a valid treatment option in boxer's fractures.
第五掌骨颈骨折（通常称为“拳击者骨折”）是最常见的掌骨损伤，通常影响年轻活跃人群。这些损伤主要采用保守治疗。其手术治疗（若有指征）仍存在争议。已有多种不同的手术方法被描述。本研究的目的是评估18例采用顺行锁定弹性髓内钉固定的拳击者骨折的治疗效果。
所有患者平均随访45个月，采用上肢、肩部和手部功能障碍（DASH）评分及患者自评腕/手评估（PRWHE）进行临床评估。还分析了掌指（MP）关节、近端和远端指间（PIP和DIP）关节的主动和被动活动范围（ROM）、总主动活动度（TAM）以及握力。术前及末次随访时通过影像学测量背侧成角和轴向缩短情况。
观察到的临床和影像学结果均令人满意。患侧手与健侧对侧手在TAM和握力方面未记录到差异。
根据本研究的良好结果和低并发症发生率，顺行锁定弹性髓内钉固定可被视为拳击者骨折的一种有效治疗选择。
