Al-Qattan Mohammad M
Department of Surgery, King Saud University, Riyadh, Saudi Arabia.
Ann Plast Surg. 2012 Jul;69(1):35-7. doi: 10.1097/SAP.0b013e31821ee47b.
Closed type III phalangeal neck fractures with 180-degree rotation is a rare iatrogenic injury that occurs following failed attempts at closed reduction. Prior to closed reduction, the phalangeal head is in 90-degree rotation. Longitudinal traction during closed reduction then converts the deformity into 180-degree rotation. We present the first documented noniatrogenic case of phalangeal neck fracture with 180-degree rotation that was also associated with a displaced Salter-Harris II fracture at the same joint. The blood supply of the phalangeal head in that scenario is discussed along with precautions that should be taken during open reduction and internal fixation to avoid avascular necrosis of the phalangeal head.
伴有180度旋转的闭合性III型指骨颈骨折是一种罕见的医源性损伤，发生于闭合复位失败后。在闭合复位前，指骨头处于90度旋转状态。闭合复位时的纵向牵引随后将畸形转变为180度旋转。我们报告了首例有记录的非医源性180度旋转指骨颈骨折病例，该病例同时还伴有同一关节处移位的Salter-Harris II型骨折。文中讨论了在这种情况下指骨头的血供情况，以及切开复位内固定过程中应采取的预防措施，以避免指骨头缺血性坏死。
