MODIFIED INTRAMEDULLARY FIXATION WITH TWO Kirschner WIRES FOR EXTRA-ARTICULAR FRACTURE OF PROXIMAL PHALANGEAL BASE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIShengzhou ¹ ,  WUKewan ¹ , XIELu ¹ , CHENLin ²

1. Department of Emergency Surgery, Yinzhou No. 2 Hospital, Ningbo Zhejiang, 315100, P. R. China;
2. Department of Hand Surgery, Huashan Hospital, Fudan University;

Corresponding?author：

WUKewan, Email: wkw1976@sina.com

Keywords：

Phalanx; Basal fracture; Intramedullary fixation; Kirschner wire

DOI：

10.7507/1002-1892.20160189

Video：

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Objective To evaluate the effectiveness of the modified intramedullary fixation with two Kirschner wires for extra-articular fracture of the proximal phalangeal base. Methods Between June 2012 and November 2015, 18 cases (18 fingers) of fresh extra-articular fracture of the proximal phalangeal base were treated, including 16 males and 2 females with an average age of 31 years (range, 21-57 years). The causes included strike injury in 10 cases, fall injury in 4 cases, mechanical injury in 1 case, twist injury in 1 case, crush injury in 1 case, and cutting injury in 1 case. The injured fingers were little finger in 16 cases, ring finger in 1 case, and index finger in 1 case. Of the 18 cases, 17 had closed fractures and 1 had open fracture. X-ray film showed transverse fracture in 14 cases and transverse-oblique fracture in 4 cases. The time between injury and operation was 3 hours to 4 days (mean, 2 days). After anatomical reduction, two Kirschner wires were used for intramedullary fixation. Functional exercises were done at 2 days after operation. The Kirschner wires were removed at 4 weeks after operation. Results All the wounds healed by first intention. There were no deformation, loosening or breakage of Kirschner wires, and pin tract infection. Postoperative X-ray films showed anatomical reduction of fracture in all cases; no re-displacement happened, and clinical healing was obtained at 4 weeks; bony union was obtained at 8 weeks. All patients were followed up 6-12 months with an average of 8 months. There was no pain in the metacarpophalangeal joint; the range of motion was (88.1±2.3)° at 3 months after operation, showing no significant difference when compared with normal side [(88.8±2.6)°] (t=1.73, P=0.10). The finger flexion and extension were normal; according to the criteria of total active motion of finger, the results were excellent in all cases. Conclusion The technique of modified intramedullary fixation with two Kirschner wires for extra-articular fractures of the proximal phalangeal base has the merits of convenient operation, little injury, reliable fixation, and excellent effectiveness. This technique is conducive to the recovery of hand function due to the early functional exercises.

Citation： LIShengzhou, WUKewan, XIELu, CHENLin. MODIFIED INTRAMEDULLARY FIXATION WITH TWO Kirschner WIRES FOR EXTRA-ARTICULAR FRACTURE OF PROXIMAL PHALANGEAL BASE. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(8): 935-938. doi: 10.7507/1002-1892.20160189 Copy

1.	劉亮, 呂云亮, 魏勇, 等.閉合整復AO克氏針固定治療非粉碎性指骨骨折.中華手外科雜志, 2014, 30(2):151-152.
2.	田德虎, 白江博, 張英澤, 等.微型鋼板治療掌指骨骨折的療效分析.中國修復重建外科雜志, 2009, 23(1):119-120.
3.	黃俊伍, 羅軼.指骨背側與側方放置微型鋼板治療近節指骨骨折的臨床對比研究.中華手外科雜志, 2012, 28(3):157-159.
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6.	田建, 芮永軍, 糜菁熠, 等.微型外固定支架結合有限內固定治療開放性粉碎性掌指骨骨折.中華手外科雜志, 2013, 29(1):4-6.
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9.	宋宏亮, 龔維明, 寧斌, 等.經掌指關節閉合穿釘內固定治療近節指骨骨折.山東醫藥, 2009, 49(12):20.
10.	顧玉東.如何治療手部骨折--評AO微型鋼板的應用價值.中華手外科雜志, 2002, 18(2):65.
11.	張全榮, 李向榮, 芮永軍, 等.不經關節的內固定治療掌指骨骨折.中華手外科雜志, 1995, 11(3):191-192.
12.	Xu J, Zhang C. Mini-plate versus Kirschner wire internal fixation for treatment of metacarpal and phalangeal fractures in Chinese Han population:a meta-analysis. J Orthop Surg Res, 2014, 9:24.
13.	劉愛波. AO微型鋼板與克氏針內固定治療手部關節內骨折的療效對比分析.中華手外科雜志, 2015, 31(2):145-146.
14.	Ruedi TP, Mushy WM.骨折治療的AO原則.王滿宜, 楊慶銘, 曾炳芳, 等譯.北京:華夏出版社, 2003:379-387.
15.	常剛, 許有, 閆喬生, 等.掌指骨骨折治療的臨床研究.中華手外科雜志, 2011, 27(4):251-252.
16.	王強, 張文輝, 熊革.微型鈦板掌側固定治療手指近節指骨骨折.中華手外科雜志, 2011, 27(5):313-314.

1. 劉亮, 呂云亮, 魏勇, 等.閉合整復AO克氏針固定治療非粉碎性指骨骨折.中華手外科雜志, 2014, 30(2):151-152.
2. 田德虎, 白江博, 張英澤, 等.微型鋼板治療掌指骨骨折的療效分析.中國修復重建外科雜志, 2009, 23(1):119-120.
3. 黃俊伍, 羅軼.指骨背側與側方放置微型鋼板治療近節指骨骨折的臨床對比研究.中華手外科雜志, 2012, 28(3):157-159.
4. 白印偉, 張振偉, 莊加川, 等. AO微型鈦板在近節指骨骨折中的應用.中華手外科雜志, 2010, 26(4):252.
5. 馬鑫, 孫魯源, 代杰志, 等.微型外固定架治療掌指骨開放性粉碎骨折.中國修復重建外科雜志, 2013, 27(1):17-20.
6. 田建, 芮永軍, 糜菁熠, 等.微型外固定支架結合有限內固定治療開放性粉碎性掌指骨骨折.中華手外科雜志, 2013, 29(1):4-6.
7. 王澍寰.手外科學.北京:人民衛生出版社, 1999:257-275, 466.
8. 于家傲, 路來金, 劉志剛, 等.閉合內固定術治療手部掌指骨骨折的臨床研究.中華手外科雜志, 2003, 19(2):77-79.
9. 宋宏亮, 龔維明, 寧斌, 等.經掌指關節閉合穿釘內固定治療近節指骨骨折.山東醫藥, 2009, 49(12):20.
10. 顧玉東.如何治療手部骨折--評AO微型鋼板的應用價值.中華手外科雜志, 2002, 18(2):65.
11. 張全榮, 李向榮, 芮永軍, 等.不經關節的內固定治療掌指骨骨折.中華手外科雜志, 1995, 11(3):191-192.
12. Xu J, Zhang C. Mini-plate versus Kirschner wire internal fixation for treatment of metacarpal and phalangeal fractures in Chinese Han population:a meta-analysis. J Orthop Surg Res, 2014, 9:24.
13. 劉愛波. AO微型鋼板與克氏針內固定治療手部關節內骨折的療效對比分析.中華手外科雜志, 2015, 31(2):145-146.
14. Ruedi TP, Mushy WM.骨折治療的AO原則.王滿宜, 楊慶銘, 曾炳芳, 等譯.北京:華夏出版社, 2003:379-387.
15. 常剛, 許有, 閆喬生, 等.掌指骨骨折治療的臨床研究.中華手外科雜志, 2011, 27(4):251-252.
16. 王強, 張文輝, 熊革.微型鈦板掌側固定治療手指近節指骨骨折.中華手外科雜志, 2011, 27(5):313-314.

Chinese Journal of Reparative and Reconstructive Surgery

MODIFIED INTRAMEDULLARY FIXATION WITH TWO Kirschner WIRES FOR EXTRA-ARTICULAR FRACTURE OF PROXIMAL PHALANGEAL BASE

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