Research Institute of Orthopedics, the Affiliated Jiangnan Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou, China.
J Int Med Res. 2023 May;51(5):3000605231174981. doi: 10.1177/03000605231174981.
This retrospective study compared two minimally invasive surgical methods for fifth metacarpal neck fractures in adolescents: percutaneous Kirschner wire (K-wire) fixation and elastic stable intramedullary nailing (ESIN).
This study involved 42 adolescents aged 11 to 16 years with fifth metacarpal neck fractures treated by either K-wire fixation (n = 20) or ESIN (n = 22). The palmar tilt angle and shortening were compared on radiographs preoperatively and 6 months postoperatively. Total active range of motion (TAM), the visual analogue scale score for pain, and the Disabilities of the Arm, Shoulder and Hand score for upper limb function were recorded at 5 weeks, 3 months, and 6 months postoperatively.
The mean TAM was significantly greater in the ESIN than K-wire group at all postoperative time points. The mean external fixation time was 2 weeks longer in the K-wire than ESIN group. One patient in the K-wire group developed infection. There was no statistically significant difference between the two groups in other postoperative outcomes.
ESIN fixation has the advantages of greater stability, better activity, a shorter external fixation time, and a lower infection rate than K-wire fixation in the treatment of fifth metacarpal neck fractures in adolescents.
本回顾性研究比较了青少年第五掌骨颈骨折的两种微创外科治疗方法：经皮克氏针（K 针）固定和弹性稳定髓内钉（ESIN）。
本研究纳入了 42 名 11 至 16 岁的第五掌骨颈骨折青少年患者，分别采用 K 针固定（n=20）或 ESIN（n=22）治疗。比较术前和术后 6 个月的掌倾角和缩短程度。记录术后 5 周、3 个月和 6 个月的总主动活动度（TAM）、疼痛视觉模拟评分和上肢功能的残疾程度（DASH）评分。
在所有术后时间点，ESIN 组的 TAM 均值均显著大于 K 针组。K 针组的外固定时间比 ESIN 组长 2 周。K 针组有 1 例患者发生感染。两组在其他术后结果方面无统计学差异。
与 K 针固定相比，ESIN 固定治疗青少年第五掌骨颈骨折具有稳定性更好、活动度更大、外固定时间更短、感染率更低的优点。
