Effectiveness on treatment of metacarpal avulsion fracture with Kirschner wire buckling combined with bone fixation_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANG Huanyou , WANG Bin , HUANG Lei ,  GUO Lin , LIU Zhiwang , LI Hong , MIAO Jianmei

The First Department of Hand Surgery, the Second Hospital of Tangshan, Tangshan Hebei, 063000, P. R. China;

Corresponding?author：

GUO Lin, Email: 137070822@qq.com

Keywords：

Metacarpal avulsion fracture; Kirschner wire; open reduction; internal fixation

DOI：

10.7507/1002-1892.202309024

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Objective To summarize the effectiveness of Kirschner wire buckling combined with bone fixation in the treatment of metacarpal avulsion fracture. Methods The clinical data of 35 patients of metacarpal avulsion fracture admitted between March 2017 and June 2022 were retrospectively analyzed. There were 22 males and 13 females; the age ranged from 20 to 55 years, with an average of 31.6 years. There were 17 cases of the second metacarpal avulsion fracture, 6 cases of the fourth metacarpal avulsion fracture, and 12 cases of the fifth metacarpal avulsion fracture. The causes of injury included 21 cases of strangulation, 8 cases of sprain, and 6 cases of sports injury. X-ray film examination showed that the size of the avulsion fracture of metacarpal bone ranged from 0.30 cm×0.20 cm to 0.55 cm×0.45 cm. The total active motion (TAM) of the injured finger before operation was (154.00±17.38)°. The time from injury to operation was 3-10 days, with an average of 5.8 days. Follow-up regularly after operation, X-ray film and CT examination were performed to evaluate fracture healing and TAM of injured finger was measured. The finger function was evaluated by the trial standard of upper limb function evaluation of Hand Surgery Society of Chinese Medical Association. Results All the incisions healed by first intention. All 35 patients were followed up 9-36 months, with an average of 28 months. All metacarpal avulsion fractures achieved bony healing, and the healing time was 4-6 weeks, with an average of 4.8 weeks. The metacarpophalangeal joint of the patient was stable, without stiffness, and the flexion and extension activities were good. At last follow-up, the TAM of the injured finger reached (261.88±6.23)°, which was significantly different from that before operation (t=?35.351, P<0.001). The finger function was evaluated according to the trial standard of upper limb function evaluation of the Society of Hand Surgery of Chinese Medical Association, and 33 cases were excellent and 2 cases were good, with an excellent and good rate of 100%. Conclusion The treatment of metacarpal avulsion fracture with Kirschner wire buckling combined with bone fixation has the advantages of less trauma, firm fixation, and less interference to the soft tissue around metacarpophalangeal joints, which is a good alternative method for the metacarpal avulsion fracture.

Citation： YANG Huanyou, WANG Bin, HUANG Lei, GUO Lin, LIU Zhiwang, LI Hong, MIAO Jianmei. Effectiveness on treatment of metacarpal avulsion fracture with Kirschner wire buckling combined with bone fixation. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(11): 1390-1393. doi: 10.7507/1002-1892.202309024 Copy

1.	潘生德, 顧玉東, 侍德. 中華醫學會手外科學會上肢部分功能評定試用標準. 中華手外科雜志, 2000, 16(3): 130-135.
2.	湯樣華, 曾林如, 李永福, 等. 折斷釘固定治療掌骨頭骨折. 中華手外科雜志, 2016, 32(6): 414-415.
3.	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.
4.	劉剛義, 楊偉超, 王春旭, 等. 克氏針聯合張力帶鋼絲固定掌指關節內骨折的臨床觀察. 中華手外科雜志, 2023, 39(2): 119-121.
5.	鄭炎強, 李進波. 微型鋼板內固定治療掌指關節周圍骨折的效果分析. 實用手外科雜志, 2023, 37(1): 72-75.
6.	李強, 薄連洪, 張志強, 等. 應用微型骨錨治療掌骨頭撕脫骨折. 中華手外科雜志, 2013, 29(1): 33.
7.	勞杰, 顧玉東, 徐建光, 等. 掌骨頭關節內骨折的治療. 中華手外科雜志, 2004, 20(4): 213-215.
8.	呂福洲, 湯美玉, 聶強, 等. 微型鋼板和克氏針內固定治療掌指骨骨折的臨床效果對比. 山西醫藥雜志, 2021, 50(12): 1946-1949.
9.	張春暉, 劉繼, 劉喜波, 等. 微型鉤狀鎖定鈦板內固定治療掌指關節內撕脫骨折. 中華創傷雜志, 2020, 36(2): 153-158.
10.	Freeland AE, Finley JS. Displaced dorsal oblique fracture of the hamate treated with a cortical mini lag screw. J Hand Surg (Am), 1986, 11(5): 656-658.
11.	雷偉, 王錕, 劉毅強, 等. Orthofix外固定支架治療累及關節的閉合掌指骨骨折. 中華手外科雜志, 2020, 36(3): 187-189.
12.	朱澤興, 張樹明, 劉春生, 等. Ishiguro法治療可復性陳舊性骨性錘狀指短期療效分析. 中華手外科雜志, 2015, 31(2): 94-95.
13.	楊煥友, 王斌, 李瑞國, 等. 雙扣壓法治療骨性錘狀指. 中華手外科雜志, 2020, 36(6): 469-470.
14.	楊煥友, 王斌, 王偉, 等. 克氏針扣壓聯合經骨折塊內固定治療中節指骨基底背側撕脫骨折并中央腱止點損傷. 中國骨與關節損傷雜志, 2022, 37(3): 321-322.
15.	Neuhaus V, Thom s MA, Mudgal CS. Type Ⅱb bony mallet finger: is anatomical reduction of the fracture necesssary. Am J Orthop (Belle Mead NJ), 2013, 42(5): 223-226.

1. 潘生德, 顧玉東, 侍德. 中華醫學會手外科學會上肢部分功能評定試用標準. 中華手外科雜志, 2000, 16(3): 130-135.
2. 湯樣華, 曾林如, 李永福, 等. 折斷釘固定治療掌骨頭骨折. 中華手外科雜志, 2016, 32(6): 414-415.
3. 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.
4. 劉剛義, 楊偉超, 王春旭, 等. 克氏針聯合張力帶鋼絲固定掌指關節內骨折的臨床觀察. 中華手外科雜志, 2023, 39(2): 119-121.
5. 鄭炎強, 李進波. 微型鋼板內固定治療掌指關節周圍骨折的效果分析. 實用手外科雜志, 2023, 37(1): 72-75.
6. 李強, 薄連洪, 張志強, 等. 應用微型骨錨治療掌骨頭撕脫骨折. 中華手外科雜志, 2013, 29(1): 33.
7. 勞杰, 顧玉東, 徐建光, 等. 掌骨頭關節內骨折的治療. 中華手外科雜志, 2004, 20(4): 213-215.
8. 呂福洲, 湯美玉, 聶強, 等. 微型鋼板和克氏針內固定治療掌指骨骨折的臨床效果對比. 山西醫藥雜志, 2021, 50(12): 1946-1949.
9. 張春暉, 劉繼, 劉喜波, 等. 微型鉤狀鎖定鈦板內固定治療掌指關節內撕脫骨折. 中華創傷雜志, 2020, 36(2): 153-158.
10. Freeland AE, Finley JS. Displaced dorsal oblique fracture of the hamate treated with a cortical mini lag screw. J Hand Surg (Am), 1986, 11(5): 656-658.
11. 雷偉, 王錕, 劉毅強, 等. Orthofix外固定支架治療累及關節的閉合掌指骨骨折. 中華手外科雜志, 2020, 36(3): 187-189.
12. 朱澤興, 張樹明, 劉春生, 等. Ishiguro法治療可復性陳舊性骨性錘狀指短期療效分析. 中華手外科雜志, 2015, 31(2): 94-95.
13. 楊煥友, 王斌, 李瑞國, 等. 雙扣壓法治療骨性錘狀指. 中華手外科雜志, 2020, 36(6): 469-470.
14. 楊煥友, 王斌, 王偉, 等. 克氏針扣壓聯合經骨折塊內固定治療中節指骨基底背側撕脫骨折并中央腱止點損傷. 中國骨與關節損傷雜志, 2022, 37(3): 321-322.
15. Neuhaus V, Thom s MA, Mudgal CS. Type Ⅱb bony mallet finger: is anatomical reduction of the fracture necesssary. Am J Orthop (Belle Mead NJ), 2013, 42(5): 223-226.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness on treatment of metacarpal avulsion fracture with Kirschner wire buckling combined with bone fixation

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