摘要目的 探讨闭合穿针治疗掌指关节周围部位骨折的临床疗效.方法 2005年以来,对17例掌骨颈或近节指骨基底部骨折患者,采用C型臂X线机透视下闭合复位克氏针内固定治疗.单部位骨折11例,其中掌骨头或颈部骨折7例,近节指骨基底部骨折4例;多部位骨折6例,其中2处以上掌骨颈骨折3例,2～5指近节指骨基底部均骨折1例,2～4指近节指骨基底部均骨折1例,第五掌骨颈骨折伴环指近节指骨基底部骨折1例.均为闭合性骨折.急诊手术4例,伤后5 d内手术12例,伤后11 d手术1例.术后2-3周拆除石膏,4周拔克氏针.结果 术后X线片显示骨折均达到良好复位.随访6～9个月,骨折愈合良好.手功能按TAM系统评定法评定:优13例,良4例.结论 闭合穿针治疗掌指关节部位骨折创伤小、方法简单、疗效佳,是治疗掌指关节部位骨折理想的方法.

abstractsObjective To assess the clinical outcomes of treating periartieular fractures of the metacarpophalangeal ioint with closed reduelion and percutaneous K-wire fixation.Methods Since 2005,17cases of metacarpal neck fractures or proximal phalanx base fraetures were treated by closed reduction and percutaneous K-wire fixation under fluoroscopic monitoring.There were 11 simple fractures including 7 at the metacarpal head or neck and 4 at the proximal phalanx base.Six cases had fractures involving multiple digits.There were 3 cases of metacarpal neck fractures at more than 2 digits,1 case of proximal phalanx base fractures involving digit 2 to 5,1 case of proximal phalanx base fractures of diglt 2 to 4,and 1 case of metacarpal neck fracture of digit 5 and proximal phalanx base fracture ofdigit 4.All the fracmres were dose fractures.Four cases were operated the day of the injury,12 cases at 5 days after the injury,and 1 case at 11 days after the injury.Gtst was removed 2 to 3 weeks p06toperatively.K-wires were removed 4 weeks poetoperatively.Results Postoperative X-rays showed good reduction in all cases.Follow up period ranged from 6 to 9 months.Au the fractures were well healed.The hand function was evaluated by TAM system which was graded as excellent in 13 cases and good in 4 cases.Conclusion Close reduction and percutaneous pinning is nil ideal way to treat periarticular fractures of the metacarpophalangeal joint.It is minimnally invasive,simple and effective.