Wong Victor W, Higgins James P
Baltimore, Md.
From The Curtis National Hand Center.
Plast Reconstr Surg. 2017 Jul;140(1):140e-151e. doi: 10.1097/PRS.0000000000003470.
After reading this article, the participant should be able to: 1. Understand metacarpal anatomy and its role in fracture pathology. 2. Determine when surgical intervention is needed for metacarpal fractures. 3. Understand the various treatment options for surgical fixation of metacarpal fractures. 4. Describe the role for external fixation in managing difficult metacarpal fractures.
Metacarpal fractures are common injuries that plastic surgeons should be able to evaluate and treat. The goal of this review is to highlight current evidence for managing metacarpal fractures. This Continuing Medical Education article consists of a literature review, illustrations, videos, and an online Continuing Medical Education examination.
The authors reviewed the scientific literature from 2000 to 2015 regarding treatment of metacarpal fractures. Cadaver models were used for instructional videography demonstrating common surgical techniques. Multiple-choice questions were created to review pertinent topics. A discussion and references are provided.
Numerous treatment options have been described for metacarpal fractures, including splinting, percutaneous fixation, open reduction with internal fixation, and external fixation. All modalities are acceptable strategies for treating metacarpal fractures. The ultimate goal is to maximize hand function with minimal morbidity.
A thorough understanding of treatment modalities is helpful in evaluating and managing metacarpal fractures. Although the current literature supports a wide array of treatment strategies, high-level evidence to guide fracture management remains lacking.
阅读本文后，读者应能够：1. 理解掌骨解剖结构及其在骨折病理中的作用。2. 确定何时需要对掌骨骨折进行手术干预。3. 了解掌骨骨折手术固定的各种治疗选择。4. 描述外固定在处理复杂掌骨骨折中的作用。
掌骨骨折是整形外科医生应能够评估和治疗的常见损伤。本综述的目的是强调当前处理掌骨骨折的证据。这篇继续医学教育文章包括文献综述、插图、视频以及在线继续医学教育考试。
作者回顾了2000年至2015年关于掌骨骨折治疗的科学文献。使用尸体模型进行教学摄像，展示常见的手术技术。编制了多项选择题以复习相关主题。提供了讨论和参考文献。
已描述了多种治疗掌骨骨折的选择，包括夹板固定、经皮固定、切开复位内固定和外固定。所有这些方法都是治疗掌骨骨折的可接受策略。最终目标是以最小的发病率最大化手部功能。
全面了解治疗方法有助于评估和处理掌骨骨折。尽管当前文献支持多种治疗策略，但仍缺乏指导骨折处理的高级别证据。
