Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.
Sci Rep. 2017 Oct 2;7(1):12516. doi: 10.1038/s41598-017-12771-z.
Fifth metacarpal neck fracture commonly requires open reduction and internal fixation. Locking plate was widely adopted in the treatment of fifth metacarpal neck fracture as first-line choice for fixation. Patients with fifth metacarpal neck fracture receiving locking plate fixation were included for analysis. Features of internal fixation including number of distal and proximal locking screws, diameter of the screws and usage of lag screws were recorded. Clinical and radiographic outcomes included final volar angulation, grip strength, Michigan Hand Outcomes Questionnaire (MHQ) and range of motion (ROM) of fifth metacarpophalangeal joint. Three-screw fixation was less frequently presented in the group with increased volar angulation (≥30 degrees). Consistently, three-screw fixation of distal fragment could improve the prognosis compared with two-screw fixation (MHQ 95.4 ± 5.1 versus 80.4 ± 12.3, ROM 83.5 ± 7.2 versus 69.6 ± 7.7). In conclusion, the metacarpal head should be fixed by three locking screws instead of two locking screws.
第五掌骨颈骨折通常需要切开复位内固定。锁定板被广泛应用于第五掌骨颈骨折的治疗中，作为固定的首选方法。对接受锁定板固定的第五掌骨颈骨折患者进行分析。记录内固定的特征，包括远端和近端锁定螺钉的数量、螺钉的直径和拉力螺钉的使用情况。临床和影像学结果包括最终掌侧成角、握力、密歇根手功能问卷（MHQ）和第五掌指关节活动度（ROM）。在掌侧成角增加（≥30 度）的患者中，三枚螺钉固定的情况较少。同样，与两枚螺钉固定相比，三枚螺钉固定远节断端可以改善预后（MHQ95.4±5.1 比 80.4±12.3，ROM83.5±7.2 比 69.6±7.7）。总之，掌骨头应该用三根锁定螺钉固定，而不是两根锁定螺钉。
