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首页> 外文期刊>Journal of Hand Surgery. American Volume >Management of neglected Bennett fracture in manual laborers by tension fixation
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Management of neglected Bennett fracture in manual laborers by tension fixation

机译：通过张力固定术治疗体力劳动者被忽视的Bennett骨折

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Purpose To report the results of open reduction and internal fixation (ORIF) of Bennett fractures in young, active patients using a K-wire and wire loop construct to achieve anatomical reduction and to allow return to manual labor. Methods In this prospective series, we treated 10 male manual laborers (mean age, 30 y; range, 20-44 y) with Bennett fractures diagnosed after a minimum of 12 weeks (mean, 16 wk; range, 12-18 wk). ORIF using 2 K-wires with a wire loop and a neutralizing transarticular K-wire was performed with direct articular visualization. Patients were evaluated for range of motion, grip strength, and pinch strength, and a visual analog scale score rated pain before surgery and 12 months later. Results The mean follow-up was 16 months (range, 12-36 mo). The average visual analog scale improved from 6 to 2, mean palmar abduction improved from 15° to 40°, mean radial abduction increased from 22° to 39°, average pinch strength improved from 9.9 kg to 15.5 kg, and average grip strength increased from 34 kg to 49 kg. Complications included transient irritation of the radial sensory nerve or lateral cutaneous nerve of the forearm in 3 patients, pin track granuloma formation in 2 patients, and marginal osteophyte formation in 2 patients. Union was achieved in all 10 patients, and 9 patients returned to their previous manual labor occupation. Conclusions Our results suggest that neglected Bennett fractures can be effectively managed by ORIF using K-wires and a wire loop without compromising strength or motion. This technique reliably restored the anatomy and provided adequate thumb motion and strength to allow a return to manual labor.
机译：目的报告使用K线和线环构造实现解剖复位并允许重返体力劳动的年轻活跃患者的Bennett骨折的开放复位和内固定（ORIF）结果。方法在本前瞻性研究中，我们治疗了10名男性体力劳动者（平均年龄30岁;范围20-44岁），并经至少12周（平均16周;范围12-18周）诊断为Bennett骨折。使用带有线环的2条K线和中和的经关节K线进行ORIF，并通过直接关节可视化进行。对患者的运动范围，握力和捏力进行了评估，并以视觉模拟评分法对手术前和术后12个月的疼痛评分。结果平均随访时间为16个月（范围12-36 mo）。平均视觉模拟量表从6改善到2，平均手掌外展从15°到40°，平均径向外展从22°到39°，平均捏力从9.9 kg提高到15.5 kg，平均抓地力从34公斤至49公斤。并发症包括前臂放射状刺激神经或前臂外侧皮神经短暂刺激3例，针迹肉芽肿形成2例，边缘骨赘形成2例。所有10例患者均实现了愈合，有9例患者恢复了以前的体力劳动职业。结论我们的结果表明，通过ORIF使用K线和线环可以有效地治疗被忽视的Bennett骨折，而不会影响强度或运动。该技术可靠地恢复了解剖结构，并提供了足够的拇指运动和力量以允许恢复体力劳动。

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