Abboudi Jack, Sandilands Scott M, Hoffler C Edward, Kirkpatrick William, Emper William
1 Rothman Institute, Philadelphia, PA, USA.
2 Larkin Community Hospital, South Miami, FL, USA.
Hand (N Y). 2018 Sep;13(5):563-571. doi: 10.1177/1558944717725376. Epub 2017 Sep 6.
Distal ulna fractures at the ulnar neck can be seen in association with distal radius fractures, and multiple techniques have been described to address the ulnar neck component of these injuries. We have found that treatment of ulnar neck fractures can be challenging in terms of anatomy and fracture fixation. We present a new percutaneous fixation technique for ulnar neck fractures commonly seen with distal radius fractures.
Fixation of the ulnar neck fracture is performed after fixation of the distal radius fracture. Our technique uses anterograde intramedullary fixation to stabilize the fracture with a 1.6-mm (0.062 inch) Kirschner wire or a commercially available metacarpal fixation intramedullary nail. The fixation is introduced into the intramedullary space of the ulnar shaft 4 to 6 cm proximal to the fracture at a separate surgical site along the subcutaneous border of the ulna. The fixation is also supported with a sugar-tong splint for the first few weeks after surgery and requires removal of the ulnar implant approximately 10 weeks after implantation.
Our technique utilizes a percutaneous approach with minimal fracture exposure. It provides a relatively simple and reproducible method to address ulnar neck fractures commonly seen in association with distal radial fractures.
尺骨颈远端骨折可与桡骨远端骨折同时出现，针对此类损伤的尺骨颈骨折部分，已有多种技术被描述。我们发现，尺骨颈骨折的治疗在解剖结构和骨折固定方面可能具有挑战性。我们介绍一种常用于治疗与桡骨远端骨折同时出现的尺骨颈骨折的经皮固定新技术。
在固定桡骨远端骨折后，对尺骨颈骨折进行固定。我们的技术采用顺行髓内固定，用一根1.6毫米（0.062英寸）的克氏针或市售的掌骨固定髓内钉来稳定骨折。在一个单独的手术部位，沿着尺骨的皮下边缘，在骨折近端4至6厘米处将固定装置插入尺骨干的髓腔内。术后最初几周还用糖钳夹板进行辅助固定，植入后约10周需取出尺骨植入物。
我们的技术采用经皮入路，骨折暴露最小。它为处理与桡骨远端骨折同时出现的常见尺骨颈骨折提供了一种相对简单且可重复的方法。
