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使用两根克氏针弹性固定锤状指骨折：一种新型固定技术的病例报告

Elastic fixation of mallet finger fractures using two K-wires: A case report of a new fixation technique.

作者信息

Chen Qiang, Suo Yan, Pan Danhong, Xie QingPing

机构信息

Department of Hand Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, P.R. China.

出版信息

Medicine (Baltimore). 2019 May;98(20):e15481. doi: 10.1097/MD.0000000000015481.

DOI:10.1097/MD.0000000000015481
PMID:31096445
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6531267/
Abstract

RATIONALE

Mallet finger fracture is a common sports-related injury that may lead to the tearing of extensor tendon and protrusion of a bony fragment located at the base of the distal phalanx. We affirmed that the elastic fixation of with two K-wires technique is a good method to deal with Mallet Finger fractures that fractures could gain effective fixation than the conventional treatment method and avoid surgical incision complication PATIENT CONCERNS:: We reported a 33-year-old female patient came to our hospital complaining of mild pain, swelling and her right little finger was deformed because of sport's injury.

DIAGNOSIS

Acute mallet finger fracture type IV B according to Doyle classification of mallet injuries.

INTERVENTIONS

We performed an emergency operation for the elastic fixation of the mallet finger fractures with two K-wires.

OUTCOMES

After the surgery, the patient showed functional recovery. No evidence of recurrence was noted 6 months after the operation, and the patient showed no symptoms of sports-related injuries.

LESSONS

We discuss the clinical diagnosis, treatment, and follow-up of the patient and suggest that elastic fixation with two K-wires is a good method to treat mallet finger fractures.

摘要

理论依据

锤状指骨折是一种常见的运动相关损伤，可能导致伸肌腱撕裂以及位于远节指骨基部的骨碎片突出。我们证实，双克氏针弹性固定技术是治疗锤状指骨折的一种好方法，该骨折能够比传统治疗方法获得更有效的固定，并避免手术切口并发症。

患者情况

我们报告了一名33岁女性患者，因运动损伤前来我院就诊，主诉右小指轻度疼痛、肿胀且畸形。

诊断

根据多伊尔锤状指损伤分类，为急性IV B型锤状指骨折。

干预措施

我们对该锤状指骨折行双克氏针弹性固定急诊手术。

结果

术后患者功能恢复。术后6个月无复发迹象，且患者无运动相关损伤症状。

经验教训

我们讨论了该患者的临床诊断、治疗及随访情况，并表明双克氏针弹性固定是治疗锤状指骨折的一种好方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe80/6531267/58b9af8e2778/medi-98-e15481-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe80/6531267/e974b4c5dbb9/medi-98-e15481-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe80/6531267/8fd6c874ca67/medi-98-e15481-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe80/6531267/7ed397efba6b/medi-98-e15481-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe80/6531267/58b9af8e2778/medi-98-e15481-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe80/6531267/e974b4c5dbb9/medi-98-e15481-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe80/6531267/8fd6c874ca67/medi-98-e15481-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe80/6531267/7ed397efba6b/medi-98-e15481-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe80/6531267/58b9af8e2778/medi-98-e15481-g004.jpg

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本文引用的文献

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Surgical and Nonsurgical Management of Mallet Finger: A Systematic Review.锤状指的手术与非手术治疗：一项系统评价
J Hand Surg Am. 2018 Feb;43(2):146-163.e2. doi: 10.1016/j.jhsa.2017.10.004. Epub 2017 Nov 22.
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A review of mallet finger and jersey finger injuries in the athlete.运动员中锤状指和球衣指损伤的综述。
Curr Rev Musculoskelet Med. 2017 Mar;10(1):1-9. doi: 10.1007/s12178-017-9395-6.
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The "Fish Hook" Technique for Bony Mallet Finger.用于治疗骨性锤状指的“鱼钩”技术
Orthopedics. 2016 Sep 1;39(5):295-8. doi: 10.3928/01477447-20160526-01. Epub 2016 Jun 1.
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Review of Acute Traumatic Closed Mallet Finger Injuries in Adults.成人急性创伤性闭合性锤状指损伤综述
Arch Plast Surg. 2016 Mar;43(2):134-44. doi: 10.5999/aps.2016.43.2.134. Epub 2016 Mar 18.
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Pressing fixation of mallet finger fractures with the end of a K-wire (a new fixation technique for mallet fractures).用克氏针末端加压固定锤状指骨折（一种锤状骨折的新固定技术）。
Injury. 2016 Feb;47(2):377-82. doi: 10.1016/j.injury.2015.09.018. Epub 2015 Oct 1.
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The risk factors associated with subluxation of the distal interphalangeal joint in mallet fracture.锤状指骨折中与远侧指间关节半脱位相关的危险因素。
J Hand Surg Eur Vol. 2015 Jan;40(1):63-7. doi: 10.1177/1753193414554556. Epub 2014 Oct 21.
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Mallet fingers with bone avulsion and DIP joint subluxation.伴有骨质撕脱和远侧指间关节半脱位的锤状指。
J Hand Surg Eur Vol. 2015 Jan;40(1):8-15. doi: 10.1177/1753193414554772. Epub 2014 Oct 21.
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The non-operative management of hand fractures.手部骨折的非手术治疗
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A prospective randomized controlled trial comparing night splinting with no splinting after treatment of mallet finger.一项比较锤状指治疗后夜间夹板固定与不使用夹板固定的前瞻性随机对照试验。
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Minimally invasive finger fracture management: wide-awake closed reduction, K-wire fixation, and early protected movement.微创手指骨折治疗：清醒下闭合复位、克氏针固定及早期保护性活动。
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