Afifi A M, Richards A, Medoro A, Mercer D, Moneim M
Department of Orthopaedics and Rehabilitation, University of New Mexico, New Mexico, USA.
J Hand Surg Eur Vol. 2010 Mar;35(3):188-91. doi: 10.1177/1753193409352411. Epub 2009 Dec 9.
Current approaches to the proximal interphalangeal (PIP) joint have potential complications and limitations. We present a dorsal approach that involves splitting the extensor tendon in the midline, detaching the insertion of the central slip and repairing the extensor tendon without reinserting the tendon into the base of the middle phalanx. A retrospective review of 16 digits that had the approach for a PIP joint arthroplasty with a mean follow up of 23 months found a postoperative PIP active ROM of 61 degrees (range 25-90 degrees). Fourteen digits had no extensor lag, while two digits had an extensor lag of 20 degrees and 25 degrees. This modified approach is fast and simple and does not cause an extensor lag.
目前用于近端指间（PIP）关节的治疗方法存在潜在的并发症和局限性。我们提出一种背侧入路，该入路包括在中线劈开伸肌腱，分离中央束的止点，并修复伸肌腱，而无需将肌腱重新插入中节指骨基部。对16个接受PIP关节置换术该入路的手指进行回顾性研究，平均随访23个月，发现术后PIP关节主动活动度为61度（范围25-90度）。14个手指没有伸肌滞后，而两个手指的伸肌滞后分别为20度和25度。这种改良入路快速简便，不会导致伸肌滞后。
