【摘要】 目的评价经皮克氏针髓内固定技术在掌、指骨骨折中的治疗效果。方法对84例121处手部掌骨、近节指骨新鲜骨折,在手提式X光机监视下,采用手法整复经皮克氏针髓内固定术治疗。从患者手的肌力、关节活动范围和影像学检查方面进行评价。结果术后平均随访5个月,X线片显示所有骨折均达到解剖复位或近解剖复位,平均4.2周拔除克氏针,除4例5处(均为近侧指间关节)手指伸直受限外,余均与健侧无明显差别,其患指握力与正常侧无明显差异,未出现针道感染。4处伴有近侧指间关节背侧皮肤软组织损伤,局部带蒂岛状皮瓣修复,其中2例伴有伸肌腱损伤一期修复;1例因局部皮肤及软组织挫伤严重,伤口延迟愈合,经换药后愈合。结论采用闭合复位经皮克氏针髓内固定术,具有价格低廉、损伤小、固定确切、内固定取出方便、患者易接受等优点。更多还原

【Abstract】 Objective To evaluate on the effect of treatment of metacarpal and phalangeal fractures with intramedullary fixation of Kirscher’s pin.Methods 84 cases,121 cases fresh fracture of metacarpal of hand and proximal phalanx, supervised by the portable x-ray radiograph, via the Manual Reduction intramedullary fixation of Kirscher’s pin.Evaluated from the aspect of muscle strengyh, range of motion, and the image examination of the patients’ hand. Results Followed for an average of 5 months,The X-ray showed anatomic or proximal reduction occurred in all the fractures. After an average of 4.2 weeks, the K-wire was removed. Except 4 patients 5 cases(all are the proximal interphalangeal joint)limitation of finger flexion and extension, no experienced pin channel infection. 4 cases accompanied with defect of back skin and soft tissue of proximal interpha langeal joint. Only one case delayed wound healing for severe damage of partical skin and soft tissues,healed after dressing.Conclusion With less demage,reliable fixation and low price,the techniame of inrtamedullary fixation of Kirscher’s pin is worth to be eopularied.更多还原