Gonzalez M H, Igram C M, Hall R F
Department of Orthopaedics, University of Illinois, Chicago 60612-7342, USA.
J Hand Surg Am. 1995 May;20(3):382-7. doi: 10.1016/S0363-5023(05)80091-7.
A 5-year retrospective review of 83 patients with 98 metacarpal fractures was performed. Fractures of the thumb metacarpal were excluded. Ninety-six closed metacarpal fractures were reduced closed and fixed with flexible intramedullary fixation, using multiple 0.8-mm prebent rods. Two open metacarpal fractures were also fixed with this technique. Fractures amenable to flexible intramedullary fixation include short oblique and transverse fractures. Contraindications include long oblique and bicortical comminuted fractures. The average follow-up time was 9 months (range, 2 to 34 months) with 15 patients lost to follow-up examination. All fractures went on to heal. Three complications occurred: backing out of a rod in one case and bending of the rods after repeat trauma in two. There were no infections. Flexible intramedullary nailing of specific metacarpal fractures affords excellent results with a low complication rate. Proper selection of fractures and good surgical technique are necessary to avoid complications.
对83例患者的98处掌骨骨折进行了为期5年的回顾性研究。拇指掌骨骨折被排除在外。96处闭合性掌骨骨折采用多根0.8毫米预弯髓内钉进行闭合复位和弹性髓内固定。2处开放性掌骨骨折也采用该技术固定。适合弹性髓内固定的骨折包括短斜形和横行骨折。禁忌证包括长斜形和双皮质粉碎性骨折。平均随访时间为9个月（范围2至34个月），15例患者失访。所有骨折均愈合。发生了3例并发症：1例髓内钉退出，2例在再次受伤后髓内钉弯曲。无感染发生。特定掌骨骨折的弹性髓内钉固定效果良好，并发症发生率低。正确选择骨折类型和良好的手术技术对于避免并发症是必要的。
