Calfee R P, Sommerkamp T G
Department of Orthopedic Surgery, Division of Hand Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
J Hand Surg Am. 2009 Jul-Aug;34(6):1140-7. doi: 10.1016/j.jhsa.2009.04.023.
Fracture-dislocations in the small joints of the fingers are challenging injuries. The surgeon must choose an appropriate treatment based on fracture pattern, joint stability, and injury chronicity. Fracture-dislocations of the proximal interphalangeal joint are notoriously unforgiving, with potential long-term sequelae of residual pain and stiffness. Similar injuries in the distal interphalangeal joint are more tolerant of fracture displacement and even joint subluxation. Dorsal dislocations of the metacarpophalangeal joint may be associated with shearing fractures of the metacarpal head but are most notable for the volar plate interposition that may block closed reduction.
手指小关节的骨折脱位是具有挑战性的损伤。外科医生必须根据骨折类型、关节稳定性和损伤的慢性程度选择合适的治疗方法。近端指间关节的骨折脱位 notoriously unforgiving,可能会有残留疼痛和僵硬等潜在的长期后遗症。远端指间关节的类似损伤对骨折移位甚至关节半脱位的耐受性更强。掌指关节的背侧脱位可能与掌骨头的剪切骨折有关,但最值得注意的是掌板嵌入可能会阻碍闭合复位。