#长沙头条##湖南旺旺医院#
Recently, when Xiao Zhang and his friends joked about boxing after dinner, a flash of inspiration flashed in his head, imitating the movie "Boyka" fighting techniques, clenching fists, waving fists, excited, accidentally punching the wall, and when he reacted, he found that his right hand was swollen and painful, and his activities were slightly restricted.
Xie Yiling, deputy chief physician of the Department of Orthopedics of Hunan Want Want Hospital, gave an X-ray examination of his right hand and diagnosed the 4.5th metacarpal neck fracture, also known as "boxer fracture", which was caused by direct trauma in the state of clenching a fist.
(▲The 4.5th metacarpal neck on the left side is fractured, and the dislocation is obvious)
Deputy Chief Physician Xie Yiling gave a detailed introduction to the patient's fracture: the treatment of metacarpal neck fracture is mainly aimed at correcting deformity and restoring hand function. Compared with the disadvantages of the traditional scheme of "manual reduction and plaster fixation", which is difficult to stabilize the position, long recovery time, and the large trauma and surgical scar of "open reduction plate or cross K-wire internal fixation", the minimally invasive surgery currently used in the hospital is more conducive to rapid recovery, and the advantages are that there is no incision in the fracture area, basically no pain after surgery, immediate movement of fingers, no complications such as incisional tendon adhesion, joint stiffness, etc., and the hospital can be discharged the next day after surgery.
After Xiao Zhang decided to undergo minimally invasive surgery, the orthopedic minimally invasive team worked out a diagnosis and treatment plan and a minimally invasive surgery plan.
During the operation, Deputy Chief Physician Xie Yiling avoided the extensor tendon through the accurate opening at the base of the metacarpal bone, and placed two pre-curved intramedullary needles to reduce the fracture, and the transverse steel needle used the autologous metacarpal bone as a scaffold to control the rotation, and the surgical treatment was completed in 30 minutes with only 3 small pinholes.
Minimally invasive, the right 4.5th metacarpal neck fracture was reduced with K-wires needle fixation.
Intraoperative fluoroscopic deformity correction.
(▲The postoperative wound is a pinhole, and the finger can be moved early)
After surgery, the patient had mild pain and was able to carry out finger function rehabilitation activities at an early stage, avoiding complications such as joint stiffness and adhesions. Follow-up X-rays showed good fracture reduction and good internal fixation.
After being discharged from the hospital in 2 days, he basically returned to normal life. The doctor instructed: proper functional exercise after surgery, and avoid vigorous activity. Daily needle hole disinfection, 4-5 weeks later orthopedic outpatient review, no anesthesia, the physician can remove the K-wire needle.
Xie Yiling, deputy chief physician of the Department of Orthopedics of Hunan Want Want Hospital, warmly reminded that metacarpal neck fracture is a relatively common hand fracture in clinical practice, accounting for about 20% of hand fractures. Fractures of the fourth and fifth metacarpal necks can lead to dorsal angulation deformities and decreased hand grip strength, and in severe cases, rotation and shortening. In the movie, "Boyka" handsomely waved his fists and "punched his fists in place", but he didn't know that others were carried out through professional knowledge training and safety protection. Try to avoid the harm caused by these "impulses". Don't let yourself swing your punch into a "boxer" fracture!
Hunan Medical Chat Special Author: Zhang Xing, Xie Yiling, Department of Orthopedics, Hunan Want Want Hospital
Follow @Hunan Medical Chat to get more health science information!
(Editor YT)