ABSTRACT
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.
Subject(s)
Male , Female , Humans , Young Adult , Adult , Middle Aged , Fractures, Avulsion/surgery , Fracture Fixation, Internal/methods , Metacarpal Bones/injuries , Bone Wires , Retrospective Studies , Treatment Outcome , Fractures, Bone/surgery , Hand InjuriesABSTRACT
Objective To discuss a design of flap of dorsal branches of the digital proper artery to repair pediatric middle phalanx skin defects and its effect.Methods From October,2013 to March,2015,antegrade flaps were used to treat 9 pediatric patients with skin defect in middle phalanx,the dorsal branches of the digital proper artery were used as the pedicel.The dorsal branch of digital proper nerve carried by flap was sutured with digital proper nerve in wound surface of middle phalanx,flap cutting area was 3.5 cm × 1.2 cm-2.5 cm × 0.8 cm,the donor site of flap was repaired by full thickness skin graft.Results All the 9 flaps survived,and primary healing in the wound of donor and recipient site.The 9 patients were followed up for 6-12 months,with an average of 8 months.All the flaps had soft texture and full shape,the two-point discrimination was 5-9 mm,6.5 mm on average.Conclusion To repair skin defect in the middle phalanx with flap using the dorsal branches of the digital proper artery as the pedicel and sutured the dorsal branch of digital proper nerve,combine advantages of the simplicity,high skin flap survival rate,good postoperative appearance and sensation recovery.
ABSTRACT
@#Objective To study the mechanism, pathology, diagnosis and manage strategy of cervical fracture dislocation combined with anterior spinal cord syndrome (ASCS). Methods 32 cases of cervical fracture dislocation combined with ASCS from January 2012 to September 2014 were summarized. The mechanisms of injury and pathological characteristics were analyzed. All of them received surgical treatment. Anterior approach or anterior approach combined with posterior approach was chosen according to the characteristics of injury. Results All surgical treatments were successfully performed. There were 22 cases (68.75%) with hyperflexion, 5 cases (15.62%) with vertical hit, 1 case (3.12%) with hyperextension and 4 cases (12.5%) with multiple reasons. There were 4 cases (12.5%) with simple anterior dislocation, 28 cases (87.5%) with fracture combined with anterior dislocation. Only 8 cases were successfully diagnosed as ASCS, and the others (24 cases) were generally defined as spinal cord injury. Conclusion ASCS is not so rare. Hyperflexion injury is the most common mechanism. Anterior dislocation and fracture combined with anterior dislocation are the general types of pathology. Conscientious physical examination with CT and MRI can facilitate the diagnosis. Anterior approach or combined with posterior approach could be selected according to injury mechanism.
ABSTRACT
Objective To study the mechanism, pathology, diagnosis and manage strategy of cervical fracture dislocation combined with anterior spinal cord syndrome (ASCS). Methods 32 cases of cervical fracture dislocation combined with ASCS from January 2012 to Sep-tember 2014 were summarized. The mechanisms of injury and pathological characteristics were analyzed. All of them received surgical treat-ment. Anterior approach or anterior approach combined with posterior approach was chosen according to the characteristics of injury. Re-sults All surgical treatments were successfully performed. There were 22 cases (68.75%) with hyperflexion, 5 cases (15.62%) with vertical hit, 1 case (3.12%) with hyperextension and 4 cases (12.5%) with multiple reasons. There were 4 cases (12.5%) with simple anterior disloca-tion, 28 cases (87.5%) with fracture combined with anterior dislocation. Only 8 cases were successfully diagnosed as ASCS, and the others (24 cases) were generally defined as spinal cord injury. Conclusion ASCS is not so rare. Hyperflexion injury is the most common mecha-nism. Anterior dislocation and fracture combined with anterior dislocation are the general types of pathology. Conscientious physical exami-nation with CT and MRI can facilitate the diagnosis. Anterior approach or combined with posterior approach could be selected according to injury mechanism.