Chamseddine A H, Jawish R, Zein H
Orthopaedic Surgery, Sahel General Hospital, University Medical Centre, Airport Road, Ghoubeiry, Beirut, Lebanon.
Chir Main. 2009 Sep;28(4):255-9. doi: 10.1016/j.main.2009.04.001. Epub 2009 May 3.
Volar dislocation of the proximal interphalangeal finger joint is rare. The trauma that causes this injury consists in a rotation mechanism in almost all cases. It may be initially missed and diagnosed at a late sequel stage. Closed reduction should always be attempted first but this procedure may result in failure, necessitating a surgical intervention. In irreducible cases, the surgical investigation shows a longitudinal split which separates one of the lateral bands (ulnar or radial) from the central slip of the terminal extensor tendon. In addition, the lateral band is displaced to the volar aspect of the head of the first phalanx, and partially entrapped into the proximal interphalangeal joint, the head of the first phalanx being trapped between the central slip and the displaced lateral band. Surgical relocation of the displaced lateral band gives an immediate reduction of the dislocated joint. We present a case of irreducible dislocation of the proximal interphalangeal joint of the right index finger in a 42-year-old female patient who required a surgical treatment. We present the diagnostic, anatomic and therapeutic aspects of this rare injury, together with a review of the literature.
近节指间关节掌侧脱位较为罕见。几乎在所有病例中，导致这种损伤的创伤都源于一种旋转机制。它可能在最初被漏诊，并在后期的后遗症阶段才被诊断出来。应始终首先尝试进行闭合复位，但该操作可能会失败，从而需要进行手术干预。在无法复位的病例中，手术探查显示存在纵向撕裂，使外侧束（尺侧或桡侧）之一与终末伸肌腱的中央束分离。此外，外侧束向近节指骨头的掌侧移位，并部分陷入近节指间关节，近节指骨头被困在中央束和移位的外侧束之间。移位外侧束的手术复位可使脱位关节立即复位。我们报告了一例42岁女性患者右手示指近节指间关节无法复位的脱位病例，该患者需要接受手术治疗。我们介绍了这种罕见损伤的诊断、解剖和治疗方面，并对相关文献进行了综述。
