Pfeiffer K M
Handchirurgie. 1976;8(1):17-22.
In recent years stable internal fixation of hand fractures has become more commonly used though the majority of fractures of the hand bones are still treated successfully by other orthopedic means. We feel that in selected fractures internal fixation achieves better results than conservative treatment. Operative methods with less traumatic skin incisions for the fixation of multiple metacarpal fractures are proposed. A retrograde screw fixation technique is presented which permitts application of compression in very small bone fragments, which risk to be crashed by standard screwing. Results of 60 internal fixations of carpometacarpal fractures of the first metacarpal are reported. Follow-up examination of 41 patients between 1-7 years following surgery, revealed posttraumatic arthritis only in 3 joints, although remaining small articular irregularities were frequently seen on X-ray. Secondary angulation occured in four cases in spite fixation. This was due to poor cortical fixation on the palmar side of the fracture, thus in such cases temporary plaster cast should entirely be applied.
近年来，手部骨折的稳定内固定应用得越来越普遍，不过大多数手部骨骼骨折仍通过其他骨科方法成功治愈。我们认为，对于某些特定骨折，内固定比保守治疗效果更好。本文提出了用于固定多根掌骨骨折的、皮肤切口创伤较小的手术方法。介绍了一种逆行螺钉固定技术，该技术可对非常小的骨碎片施加加压，而这些小骨碎片在标准拧入螺钉时可能有被压碎的风险。报告了60例第一掌骨掌指关节骨折内固定的结果。对41例患者术后1至7年的随访检查发现，只有3个关节出现创伤后关节炎，不过X线片上经常可见残留的小关节不平整。尽管进行了固定，仍有4例出现继发成角。这是由于骨折掌侧的皮质固定不佳，因此在这种情况下应完全应用临时石膏固定。
