Ikeda Masayoshi, Ishii Takayuki, Kobayashi Yuka, Mochida Joji, Saito Ikuo, Oka Yoshinori
Department of Orthopaedic Surgery, Tokai University Hachioji Hospital, Tokyo, Japan.
Hand Surg. 2009;14(2-3):113-9. doi: 10.1142/S0218810409004335.
The use of operative or non-operative techniques in the treatment of a volar plate avulsion fracture of the PIP joint has remained controversial. In this study, we describe the use of percutaneous K-wire fixation in 15 patients with a displaced and rotated large fragment of this injury. All processes of the technique, including reduction and interfragmental fixation, were performed with percutaneous K-wires. Mean follow-up was 14.2 months. All patients achieved bony union. Mean active motion was -1.3 degrees /86.2 degrees for the PIP joint and 0 degrees /77.5 degrees for the DIP joint and mean %TAIM was 94.6%. There were no complications. No patients complained of pain and all were able to return to their previous activity. Although this procedure is technically demanding, it reconstructs a rotated or displaced large volar plate avulsion with a low level of invasion, and achieves a satisfactory functional recovery.
在近端指间关节掌板撕脱骨折的治疗中，手术或非手术技术的应用一直存在争议。在本研究中，我们描述了对15例伴有移位和旋转大骨折块的此类损伤患者采用经皮克氏针固定的情况。该技术的所有操作，包括复位和骨折块间固定，均通过经皮克氏针完成。平均随访时间为14.2个月。所有患者均实现了骨愈合。近端指间关节的平均主动活动度为-1.3度/86.2度，远端指间关节为0度/77.5度，平均总主动活动度百分比为94.6%。无并发症发生。无患者主诉疼痛，所有患者均能够恢复至伤前活动水平。尽管该手术技术要求较高，但它能以较低的侵袭程度重建旋转或移位的大掌板撕脱骨折，并实现令人满意的功能恢复。
