Application of self-prepared Kirschner wire retractor reduction and internal fixation through ulnar dorsal approach for the treatment of Bennett fractures

B. Mao, Lei Li, Wencong Wang, Zhixi Hu, Yongli He, Qiang Wang, Ju-yu Tang
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Abstract

Objective To explore the clinical efficacy of self-prepared Kirschner wire retractor reduction and internal fixation through ulnar dorsal approach in the treatment of Bennett fractures. Methods From July 2014 to February 2018, 13 patients with Bennett fractures were treated. The first carpometacarpal ulnar dorsal approach was designed to expose the fracture and articular surface. The reduction was performed using self-prepared Kirschner wire retractor, and then the fracture was fixed with Kirschner wires. Early functional exercise was performed after the operation, and Kirschner wire was removed after 4 to 6 weeks. Results All the patients were follow-up for 6 to 24 months postoperatively with an average of 14.6 months. All the incisions achieved primary healing. Bone healing was achieved in all the patients, and the pre-traumatic activity was restored 10 weeks after the operation. The VAS score ranged from 0 to 3 with an average of 1.46. The function of affected finger was evaluated by total active motion (TAM) assessment and the results were rated as excellent in 11 cases and good in 2 cases. One patient had redness and swelling in the needle track, while the other patients had no complications such as infection of the needle track, irritation of surrounding soft tissue, loosening of Kirschner needle and re-dislocation of joint. Conclusion The method of reduction and fixation of Bennett fractures through ulnar dorsal approach using self-prepared Kirschner wire retractor proves to be simple and reliable, which is worthy of clinical application. Key words: Fractures,bone; Treatment outcome; Internal fixator; Reduction
自制克氏针牵开器尺背入路复位内固定治疗Bennett骨折的应用
目的探讨自制克氏针牵开器经尺背入路复位内固定治疗Bennett骨折的临床疗效。方法2014年7月~ 2018年2月对13例Bennett骨折患者进行治疗。第一种腕掌尺侧入路的目的是暴露骨折和关节面。采用自制克氏针牵开器复位,然后用克氏针固定骨折。术后进行早期功能锻炼,术后4 ~ 6周拔除克氏针。结果所有患者术后随访6 ~ 24个月,平均14.6个月。所有切口均初步愈合。所有患者均实现骨愈合,术后10周恢复创伤前活动。VAS评分范围为0 ~ 3分,平均1.46分。采用总主动运动(TAM)评价患指功能,评分优11例,良2例。1例患者出现针道红肿,其余患者无针道感染、周围软组织刺激、克氏针松动、关节再脱位等并发症。结论自制克氏针牵开器经尺背入路复位固定Bennett骨折方法简单可靠,值得临床推广应用。关键词:骨折;骨;治疗效果;内固定;减少
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