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创伤性骨折后第三掌骨部分性联合不愈合:三例报告

and Third Metacarpal Partial Coalition Nonunion After Traumatic Fracture: A Report of Three Cases.

作者信息

Azócar Camila, Gulde Maria Lua, Hagert Elisabet

机构信息

Clínica INDISA, Hand Surgery Department, Santiago, Chile.

Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar.

出版信息

Hand (N Y). 2025 Feb 19:15589447251317232. doi: 10.1177/15589447251317232.

Abstract

The (OS) is an accessory carpal bone located in the dorsal aspect of the wrist between the base of the second and third metacarpal bones and the trapezoid and the capitate. It is frequently partially coalited with the metacarpal bones and is usually asymptomatic. It may become symptomatic after a traumatic fracture, developing swelling, edema, and pain. We report 3 cases with a fracture of an OS partial coalition with the third metacarpal bone with signs of delayed consolidation. They all complain of persistent pain at the dorsal aspect of the hand that increased with activity. One patient rejected surgery, had a platelet-rich plasma injection, shock wave therapy, and afterward did physiotherapy rehabilitation without complete solution; the other two patients underwent surgical excision with local anesthesia and had a complete recovery after 2 months of follow-up. The OS is an infrequent entity yet must be correctly diagnosed as a possible cause of dorsal pain in the hand and wrist. If symptoms are refractory to medical treatment, surgical excision should be considered. Open excision under local anesthesia is a simple, reproducible procedure with excellent results.

摘要

小多角骨是一块位于腕背侧、第二和第三掌骨基部与大多角骨和头状骨之间的副腕骨。它常与掌骨部分融合,通常无症状。在外伤性骨折后可能出现症状,表现为肿胀、水肿和疼痛。我们报告3例小多角骨与第三掌骨部分融合处骨折且有延迟愈合迹象的病例。他们均主诉手部背侧持续疼痛,活动时加重。1例患者拒绝手术,接受了富血小板血浆注射、冲击波治疗,之后进行物理治疗康复,但未完全缓解;另外2例患者在局部麻醉下接受了手术切除,随访2个月后完全康复。小多角骨是一种罕见的情况,但必须正确诊断为手部和腕部背侧疼痛的可能原因。如果症状对药物治疗无效,应考虑手术切除。局部麻醉下的开放性切除是一种简单、可重复的手术,效果良好。

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