Duan W, Zhang X, Yu Y, Zhang Z, Shao X, Du W
Department of Hand Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, PR China.
Department of Hand Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, PR China.
Hand Surg Rehabil. 2019 Feb;38(1):44-51. doi: 10.1016/j.hansur.2018.09.005. Epub 2018 Oct 11.
We aimed to describe the treatment of comminuted fractures of the base of the thumb metacarpal using a cemented bone-K-wire frame. Between March 2010 and January 2016, 41 fractures of the base of the thumb were treated using a cemented bone-K-wire frame. The mean age of the patients was 34 years. The patients' history included a fall onto the hand in 7 cases, direct trauma in 31 cases, and polytrauma with an unclear mechanism of injury in 3 cases. At the final follow-up, hand grip and pinch strength were measured using a dynamometer. All measurements were compared with those of the opposite hand. The patients were assessed functionally using the Smith and Cooney score.All K-wires were left in place until the bone healed. Bone healing was achieved in all thumbs in an average of 5.2 weeks. Follow-up averaged 27 months. The mean hand pinch and grip strength was 8.7 kg ± 2.4 kg and 38.4 kg ± 5.9 kg, respectively. The mean measurements on the opposite side were 9.2 kg ± 2.5 kg and 40.2 kg ± 6.6 kg, respectively. Based on the Smith and Cooney score, we obtained an average score of 87 ± 9.3, with 25 excellent, 9 good, and 2 fair results. The cemented bone-K-wire frame is an external fixator alternative that can be used for treating comminuted intra-articular fractures of the base of the thumb metacarpal. The system is cheap, easy to apply, and provides rigid fixation, resulting in good functional recovery.
我们旨在描述使用骨水泥-K 线框架治疗拇指掌骨基底粉碎性骨折的方法。2010 年 3 月至 2016 年 1 月期间，41 例拇指基底骨折采用骨水泥-K 线框架进行治疗。患者的平均年龄为 34 岁。患者的受伤史包括：7 例手部着地跌倒伤，31 例直接创伤，3 例机制不明的多发伤。在末次随访时，使用测力计测量握力和捏力。所有测量值均与对侧手进行比较。采用 Smith 和 Cooney 评分对患者进行功能评估。所有克氏针均保留至骨折愈合。所有拇指平均在 5.2 周时实现骨折愈合。随访平均时间为 27 个月。平均捏力和握力分别为 8.7 kg±2.4 kg 和 38.4 kg±5.9 kg。对侧相应测量值的均值分别为 9.2 kg±2.5 kg 和 40.2 kg±6.6 kg。根据 Smith 和 Cooney 评分，我们获得的平均评分为 87±9.3，其中 25 例为优，9 例为良，2 例为可。骨水泥-K 线框架是一种外固定器替代方案，可用于治疗拇指掌骨基底的粉碎性关节内骨折。该系统价格便宜、易于应用，并能提供坚强固定，从而实现良好的功能恢复。
