Method of treating fifth metacarpal fracture

FIELD: medicine.

SUBSTANCE: point skin incision is made in a projection of a base of the 5th metacarpal bone, and a pin is inserted into a canal of the 5th metacarpal bone to reach a fracture level. That is followed by closed reduction of the fracture, and the pin is inserted transarticularly up to the level of a lower one-third of a proximal phalanx of a little finger.

EFFECT: more effective treatment ensured by the stable fixation of comminuted, spiral fractures and eliminating purulent-septic complications.

1 ex, 3 dwg

 

The invention relates to the field of medicine, namely to traumatology and orthopedics.

The known method of fixation of fractures of tubular bones of the brush, which consists in transosseous (transoxania) dificatio fracture spokes by means of retrograde conduction spokes [1]. Method is used when subcapitals and diaphyseal fractures of the metacarpal bones, where the bone is held one or two spokes of Kirchner. As a prototype the selected variant of this method with the use of one of the spokes of Kirchner (Fig. 1).

After execution of closed reduction of fracture 1 V metacarpal hand bones spoke Kirchner 2 is carried out through the damaged bone head 3 in the head adjacent metacarpal bones 4, produce after plaster immobilization splints.

However, this method has the following disadvantages:

- it is left on the skin surface end of the spokes can cause purulent-septic complications;

the needle can migrate;

- subjective discomfort for the patient;

- the necessity of dressing in a month, and more importantly, this variant of the osteosynthesis does not provide sufficient fixation in comminuted, spiral and other unstable fractures of V metacarpal bones of the hand.

The disadvantages of the proposed method also includes the fixation of adjacent intact bone, which in turn causes the movement of the adjacent pastafarianism joint.

The object of the invention is to improve the efficiency of treatment of fracture of V metacarpal bones of the hand.

The technical result is that a stable fixation in comminuted, spiral and other unstable fractures of V metacarpal bones of the hand; excludes purulent-septic complications on the skin surface that occur around the end of the spokes protruding cutaneous and migration of the spokes, because around the spokes is formed osteolysis; provides less discomfort for the patient.

This is due to the fact that in the projection bases V metacarpal hand bones produce point-like incision of the skin and insert the needle into the channel V metacarpal bones to the level of the fracture, and after a closed fracture reduction needle spend transarticular to the level of the lower third phalanx V of the finger.

The proposed method of fixation of fractures of the fifth metacarpal bone is stable due to the fact that current through the base and the line of fracture of the metacarpal of the needle reaches the main phalanx of the finger and thus shineray fracture. Additional bracing is not required because there is no motion in the metacarpophalangeal joint, occurs secondary displacement of fragments. Adjacent joints intact.

Excluded purulent-septic complications on the skin surface that occur around the speaker n�skin end of the spokes according to the method prototype, but in the proposed method, the needle is immersed subcutaneously, which in turn eliminates the migration of spokes; provides less discomfort for the patient (above the skin surface of the brush nothing stands, there is no need to plaster immobilization and bandaging, not damaged healthy adjacent metacarpal bone; no limitation of motion in the adjacent metacarpophalangeal joint).

The invention is illustrated by the following images:

Fig. 1 - option of fixation of the fracture by the method prototype;

Fig. 2 - fixing the spokes of the V fracture of the metacarpal of the proposed

method;

Fig. 3 - x-ray of a clinical example of the implementation of the proposed method (before and after the operation).

The method is carried out as follows (Fig. 2): in the projection bases V metacarpal bones of the brush 4 is point a skin incision. Through the base of the metacarpal bone in her channel hold the needle Kirchner 2 to the level of the fracture 1. Perform closed reduction of fracture 1 and its fixation by further carrying out the knitting needles 2 through the head of the damaged bone 3 to the level of the lower third phalanx V finger 5. The wound is sutured. After 3 weeks the same access, make a removal of the needles, after x-ray control, followed by physiotherapy.

This method of fixation, as well as the continuation of treatment, the Rg control and removal of metallomics�Directors is carried out as an outpatient (clinics and urgent care facilities) in low operating, which significantly reduces costs for treating patients in the hospital and reduces the load on the hospitals.

Clinical example: Patient K., 28, No. And/B 13-01850, DS: Closed subcapital fracture of V metacarpal bones of the left hand with displacement of fragments.

Was completed: accessed point a skin incision at the base of V metacarpal bones. Through its base in the channel held the spokes of Kirchner to the level of the fracture. Performed closed reduction and further transarticular fixation of the needle to the level of n/3 phalanx V finger. Radiological control (under control of the Tube).

The wound closure. Plaster immobilization was carried out. After 3 weeks the same access needle is removed, and then held therapeutic exercises. Observation was 6 weeks, range of motion in joints of fingers fully restored.

The list of references

1. V. Chernavsky A., Panfilov V. M. Treatment of multiple fractures of metacarpal bones and phalanges of fingers, in proc. materials square township rights. Vseros. nauch.-method. about the society of traumatologists and orthopedists. - M., 1975, Pp. 24-25).

The method of fixation of fractures of V metacarpal hand bones, consisting of closed reduction and fixation of the needle fractures, characterized in that in the projection bases V metacarpal hand bones produce point-like incision of the skin and insert the needle into the channel V metacarpal bones to the level of the fracture, and p�should of closed reduction of fractures of the needle is carried out transarticular to the level of the lower third phalanx V finger.



 

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