Zhang Xu, Shao Xinzhong, Zhang Zheming, Zhang Guisheng, Yu Yadong, Wang Li, Lyu Li
Department of Hand Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, China.
Department of Hand Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, China.
Injury. 2018 Feb;49(2):351-358. doi: 10.1016/j.injury.2017.10.012. Epub 2017 Oct 9.
The objective of this report is to introduce an external-fixation technique using the combination of K-wires and cement.
From February 2009 to January 2015, 51 patients with shaft fractures of middle phalanges were treated with cemented K-wire fixation. The mean age of patients at surgery was 41 years. The mean time interval from injury to operation was 6±5.78days. Injured digits included index (n=18), long (n=15), ring (n=7), and little (n=11) fingers. Types of fractures were transversal (n=32), short oblique or spiral (n=5), and comminuted (n=14) fractures. Active range of motion of the fingers was measured. Total active motion was scored based on the American Society for Surgery of the Hand. All measurements were compared with those on the opposite fingers. Patients also reported on their satisfaction using the 100-mm visual analogue scale.
At the final follow-ups of 2 years, range of motion of metacarpophalangeal joint, proximal phalangeal joint, and distal interphalangeal joint reached 97%±2.88, 93%±6.65, and 96%±3.22 of the opposite fingers, respectively. Based on Total active motion scoring system, we obtained 36 excellent and 15 good results. Based on VAS, patient satisfaction was 96±3.44.
The cemented K-wire fixation is a reliable technique for the treatment of shaft fractures of middle phalanges. The technique is a minimally invasive procedure with minimal complications.
Therapeutic study, Level IVa.
本报告的目的是介绍一种使用克氏针和骨水泥相结合的外固定技术。
2009年2月至2015年1月，51例中节指骨骨干骨折患者接受了骨水泥克氏针固定治疗。患者手术时的平均年龄为41岁。受伤至手术的平均时间间隔为6±5.78天。受伤手指包括示指（n = 18）、中指（n = 15）、环指（n = 7）和小指（n = 11）。骨折类型为横行骨折（n = 32）、短斜形或螺旋形骨折（n = 5）和粉碎性骨折（n = 14）。测量手指的主动活动范围。根据美国手外科协会的标准对手指总主动活动进行评分。所有测量结果均与对侧手指进行比较。患者还使用100毫米视觉模拟量表报告他们的满意度。
在2年的最终随访中，掌指关节、近节指间关节和远节指间关节的活动范围分别达到对侧手指的97%±2.88、93%±6.65和96%±3.22。根据总主动活动评分系统，我们获得了36例优和15例良的结果。根据视觉模拟量表，患者满意度为96±3.44。
骨水泥克氏针固定是治疗中节指骨骨干骨折的可靠技术。该技术是一种微创手术，并发症少。
治疗性研究，IVa级。
