Teoh L C, Yong F C, Chong K C
Department of Hand Surgery, Singapore, General Hospital, Singapore.
J Hand Surg Br. 2002 Feb;27(1):31-5. doi: 10.1054/jhsb.2001.0694.
Unicondylar fractures of proximal and middle phalanges of the finger can unite with intra-articular malunion, which may result in joint pain, stiffness and deformity. There is currently no satisfactory technique of corrective osteotomy for these fractures. Extra-articular osteotomies often do not give good results and existing techniques of intra-articular osteotomy through the healed fracture site are technically difficult due to the small bone fragment, difficulty achieving stable fixation and the risk of avascular necrosis. We propose a different method of intra-articular correction with a longitudinal osteotomy and advancement of the malunited condyle. The "condylar advancement osteotomy" can overcome problems encountered with the other techniques. Excellent results were obtained in six patients.
手指近节和中节指骨的单髁骨折可能会发生关节内畸形愈合,这可能导致关节疼痛、僵硬和畸形。目前对于这些骨折尚无令人满意的截骨矫正技术。关节外截骨术往往效果不佳,而通过愈合骨折部位进行关节内截骨的现有技术在操作上存在困难,原因包括骨碎片小、难以实现稳定固定以及存在缺血性坏死的风险。我们提出一种不同的关节内矫正方法,即纵行截骨并推进畸形愈合的髁。“髁推进截骨术”可以克服其他技术所遇到的问题。6例患者取得了优异的效果。