Service de chirurgie de la main, du membre supérieur et des nerfs périphériques, université Paris-Descartes, Sorbonne Paris Cité, hôpital européen Georges-Pompidou (HEGP), Assistance publique-Hôpitaux de Paris (AP-HP), 20, rue Leblanc, 75908 Paris cedex 15, France.
Service de chirurgie de la main, du membre supérieur et des nerfs périphériques, université Paris-Descartes, Sorbonne Paris Cité, hôpital européen Georges-Pompidou (HEGP), Assistance publique-Hôpitaux de Paris (AP-HP), 20, rue Leblanc, 75908 Paris cedex 15, France.
Orthop Traumatol Surg Res. 2018 Apr;104(2):257-260. doi: 10.1016/j.otsr.2017.12.010. Epub 2018 Feb 2.
Fifth metacarpal neck fractures (boxer's fractures) are common injuries that contribute 20% of all hand fractures. Divergent percutaneous pinning (bouquet fixation) as described by Foucher has gained popularity but is challenging and at times arduous, as it requires the insertion of several slender K-wires into a narrow medullary canal. Here, we report on a simplified technique in which a single thick K-wire is inserted.
An 18/10 K-wire is bent at one end then mounted on a drill chuck. The incision is performed and the entry hole created using the K-wire, which is then advanced along the medullary canal. After reduction of the metacarpal head using the Jahss manoeuvre, the K-wire is inserted across the fracture site into the subchondral bone. Any persistent rotational malalignment is corrected by rotating the metacarpal around the K-wire. Immobilisation is by buddy taping covered by a resin guard.
We collected follow-up data for 30 patients treated using our technique, at a mean age of 32 years.
90 days after surgery, the fracture was healed in all patients. No patients had rotational malalignment. Mean operative time was 14minutes. No complications were recorded.
The use of a single thick K-wire proved simple, effective, reproducible, and rapid. No rotational malalignment occurred. This technique is faster and easier to perform than divergent pinning with multiple K-wires.
This technique can be used to treat fifth metacarpal neck fractures.
第五掌骨颈骨折（拳击手骨折）是常见的手部骨折，占所有手部骨折的 20%。Foucher 描述的分歧经皮克氏针固定（花束固定）已经很流行，但操作具有挑战性且有时很困难，因为它需要将几根细 K 形针插入狭窄的髓腔。在这里，我们报告一种简化技术，其中插入一根粗 K 形针。
将 18/10 K 形针的一端弯曲，然后安装在钻夹头上。用 K 形针进行切口并创建入口孔，然后沿髓腔推进。使用 Jahss 手法复位掌骨头后，将 K 形针穿过骨折部位插入软骨下骨。通过旋转掌骨围绕 K 形针纠正任何持续的旋转对线不良。通过使用 buddy 胶带固定，并用树脂护罩覆盖。
我们收集了使用我们的技术治疗的 30 例患者的随访数据，平均年龄为 32 岁。
术后 90 天，所有患者的骨折均愈合。无患者出现旋转对线不良。平均手术时间为 14 分钟。无并发症记录。
使用一根粗 K 形针证明简单、有效、可重复且快速。没有发生旋转对线不良。与使用多根 K 形针的分歧克氏针固定相比，这种技术更快、更容易操作。
这种技术可用于治疗第五掌骨颈骨折。
