Larkin G, Brüser P, Safi A
Abteilung für Hand-, Plastische und Wiederherstellungschirurgie, Malteser Krankenhaus in Bonn.
Handchir Mikrochir Plast Chir. 1997 Jul;29(4):192-6.
An alternative method for treating metacarpal fractures using intramedullary Kirschner-wire pinning is presented. This procedure does not immobilize the metacarpophalangeal joint, thus allowing early motion exercises of the affected hand which is of particular advantage in fractures of the metacarpal neck. Since May 1993, we have treated 33 patients with 37 fractures; the fifth metacarpal was involved in each case. An awl is used to prepare an opening in the cortex for insertion of two or three pre-bent K-wires which are then advanced distally from the base of the metacarpal bone. The hand is immobilized on a plaster splint for one week. Work load is increased after three weeks. With the exception of three cases, our patients achieved free movement of the fingers with anatomical alignment of the fracture site at the time of wire removal. Three cases were re-operated upon due to K-wire migration or fracture displacement. Ideal indications for this procedure are distal transverse and short oblique fractures.
本文介绍了一种使用髓内克氏针固定治疗掌骨骨折的替代方法。该手术不会固定掌指关节，因此允许患手早期进行活动锻炼，这在掌骨颈骨折中具有特别的优势。自1993年5月以来，我们共治疗了33例患者的37处骨折；均累及第五掌骨。使用锥子在皮质上准备一个开口，以便插入两根或三根预弯的克氏针，然后从掌骨基部向远端推进。手部用石膏夹板固定一周。三周后增加工作量。除3例患者外，我们的患者在取出克氏针时骨折部位解剖复位，手指可自由活动。3例患者因克氏针移位或骨折移位而再次手术。该手术的理想适应症是远端横行和短斜形骨折。
