Abstract:

Objective　To introduce a method and its effect of blocking entrapment fixation with three Kirschner wires in the treatment of bone mallet finger. Methods　From June 2019 to June 2022, 23 patients with bone mallet finger and avulsion fracture at the base of phalangeal phalanges in Shanghai Pudong New Area People's Hospital were retrospectively analyzed, including 16 males and 7 females, aged (32.17±7.99) years. After closed reduction, one Kirschner wire was used to fix the distal interphalangeal joint in overextension position, and two Kirschner wires were used to block the avulsion block with continuous entrapment. The three Kirschner wires were removed 6 weeks after surgery, and the activity of distal interphalangeal joint and fracture healing were observed and recorded during follow-up. Results　The average follow-up was (11.22±5.72) months, and the operative time was (46.91±11.78) minutes. One patient was cured satisfactorily after dressing change due to local skin necrosis caused by the compression of the finger dorsal side by blocking Kirschner wire. No needle tract infection or skin necrosis was found in the other patients. All patients had bone healing and good finger movement. At the last follow-up, according to the Grawford functional evaluation criteria, 13 cases were excellent, 9 cases were good, and 1 case was fair, with an excellent and good rate of 95.65%. Conclusion　Blocking entrapment fixation with three Kirschner wires in the treatment of bone mallet finger is stable and reliable, with simple operation, satisfactory effect, and clinical significance.

Key words:

Avulsion fracture, Bone mallet finger, Kirschner wire, Blocking entrapment fixation, Closed reduction

摘要：

目的　介绍一种三枚克氏针阻挡卡压固定治疗骨性锤状指的方法和效果。方法　回顾性分析2019年6月至2022年6月在上海市浦东新区人民医院治疗的23例手指末节指骨基底部撕脱骨折伴骨性锤状指患者，其中男16例、女7例，年龄（32.17±7.99）岁，采用闭合复位后一枚克氏针过伸位固定远指间关节，两枚克氏针斜形阻挡持续卡压撕脱骨块的方法。术后6周拔除克氏针，随访时观察记录患指远指间关节活动情况及骨折愈合情况。结果　术后随访均超过6个月，平均随访（11.22±5.72）个月，手术时间（46.91±11.78）min。1例患者因阻挡克氏针对手指背侧皮肤压迫而造成局部皮肤坏死，后经换药治疗，愈合满意。其余患者中无针道感染、皮肤坏死，所有患者均为骨性愈合，手指活动功能良好。末次随访时，根据Grawford功能评定标准，优13例，良9例，可1例，优良率为95.65%。结论　三枚克氏针阻挡卡压固定治疗骨性锤状指，固定稳定可靠，手术操作简单，疗效满意，具有临床意义。

关键词:

撕脱骨折, 骨性锤状指, 克氏针, 阻挡卡压固定, 闭合复位