克氏针联合张力带钢丝内固定治疗掌骨头骨折

目的 研究克氏针联合张力带钢丝内固定治疗掌骨头骨折的临床效果.方法 2003年7月一2009年3月,我院对68例84指掌骨头骨折应用克氏针张力带钢丝进行内固定,并辅以早期的功能锻炼.结果 术后,68例中65例伤口或切口一期愈合,3例骨外露,其中1例因克氏针旋转、钢丝脱落导致骨折移位.随访12～68个月,平均40个月.X片示骨折愈合时间～612周,平均8周,按TAM功能评分标准评定,优良率91%.结论 应用克氏针联合张力带钢丝内固定治疗掌骨头骨折是一种可靠的治疗方法.

The clinical application of tension band wiring for the treatment of metacarpal head fracture

Objective To study efficiency of open reduction and internal fixation of the metacarpal head fracture by using a tension band wiring technique. Methods From July 2003 to December 2008, 84 metacarpal heads in 68 patients were treated with open reduction and internal fixation by using this technique, followed by early range of motion exercises. The outcomes were evaluated by measuring the total active motion （ATM） of the digit joints. Results Primary wound healing was achieved in 65 of 68 patients. Bone exposure was noted in 3 patients. Displacement of the fracture after surgery was noted in one patient due to movement of the Kirschner wire and tension band wire. P, adiographically, bone union was observed in all metacarpal heads at a mean time of 8 weeks （range, 6 to 12 weeks）. At the final follow-up with a mean time of 40 months （range, 12 to 68 months）, the excellent to good results were obtained in 91% of the metacarpal heads based on the assessment criteria of ATM. Conclusion The Kirschner wire and tension band wiring technique is reliable for the treatment of the metacarpal head fracture.