Clinical Study Of Closed Reduction And Percutaneous Kirschner Wire Internal Fixation In The Treatment Of Bennett Fracture

Objective :To investigate the clinical effect of closed reduction and percutaneous Kirschner wire internal fixation in the treatment of Bennett fracture.Methods :The research subjects were 15 patients with Bennett fractures admitted to our hospital between April 2018 and August 2022.Under C-arm fluoroscopy,all patients were treated with closed reduction and Kirschner wire internal fixation,and the thumb was fixed in abduction and palmar position after operation.K-wires were removed according to fracture healing at 4-6 weeks after operation to guide patients to perform early functional exercise.To assess the surgical outcomes,patients’ conditions were followed up through both telephone and outpatient visits.Various evaluation standards were used,including the Kjaer-Petersen standard,Kapandji score,Cannon standard,VAS score,DASH score,S?lgeback method,grip strength,pinch strength,and Eaton-Littler staging.Results :We conducted follow-up assessments on all 15 patients over a period of 8to 57 months,with an average follow-up duration of(27.3±18.6)months.The study comprised 11 male and 4 female participants,with ages ranging from 20 to 67 years,and an average age of(44.5±14.9)years at the time of injury.Out of the 15 cases,12 patients suffered from a right hand fracture while 3 had a left hand fracture.The causes of injury were varied,with 5 cases resulting from falls,4 cases due to heavy object injuries,4 cases from traffic accidents,and 2cases from other types of injuries.The operation time ranged from 1 to 12 days,with a mean of(5.7±4.1)days.The duration of each operation ranged from 15 to 30 minutes,with an average of(23.3±5.5)minutes.Bone healing was confirmed through X-ray,and the average time for fracture healing was(6.0±0.8)weeks,with a range of 5 to 8 weeks.No instances of pin tract infection,neurovascular injury,nonunion,or malunion were observed following the operation.No needle withdrawal,prolapse or fracture occurred.One patient had loosening of Kirschner wire and healed after prolonging the fixation time of plaster support.There was no re-loss of fracture fragments and re-dislocation of joints.The finger shape is basically normal.The excellent and good rate of Kjaer-Petersen was 100 %.The average effective range of motion score of the first carpometacarpal joint was(9.6±0.6)points.The average DASH score is(2.7±2.5)points.According to the Cannon standard for evaluating wrist and palm joint mobility,11 cases were rated as excellent,3 cases as good,and 1case as poor,resulting in an excellent and good rate of 93.33%.One patient presented with intermittent pain,with a VAS score of 2 points,while the VAS scores of the other patients were 0 points.Based on the S?lgeback method,13 patients were classified as grade 0,while 1 patient was classified as grade 1.There was no notable discrepancy in grip strength and pinch strength observed between the affected side and the healthy side.One patient was diagnosed as Eaton-Littler stage II osteoarthritis by X-ray showing slightly narrowed articular space.Conclusion :Closed reduction and internal fixation with Kirschner pins is a treatment option for Bennett fractures that offers the benefits of a straightforward procedure,a brief recovery period,and no need for a second operation in the treatment of Bennett fractures.Johnson method,however,can also offer stable internal fixation,effectively prevent the loss of fracture reduction,maintain good reduction effect,hasten the healing process of the fracture,aid in the functional recovery of the carpal-acarpal joint,and produce a satisfactory curative outcome.It is worth clinically advocating as an ideal surgical approach to treating Bennett’s fracture.