Korambayil Pradeoth M, Francis Anto
Consultant Plastic Surgeons, Sushrutha Institute of Plastic, Reconstructive and Aesthetic Surgery, Elite Mission Hospital, Thrissur, India.
Indian J Plast Surg. 2011 Sep;44(3):458-66. doi: 10.4103/0970-0358.90822.
Injury following proximal interphalangeal joint fracture dislocation is determined by the direction of force transmission and the position of the joint at the time of impact. Dorsal dislocations with palmar lip fractures are the most frequently encountered. The degree of stability is directly determined by the amount of middle phalangeal palmar lip involvement.
Hemihamate arthroplasty procedure was used in the reconstruction in five cases with comminuted, impacted fractures of the proximal end of middle phalanx of the finger. Three patients were presented within 2 weeks; one patient came by one month and the other by three months following the injury. All patients presented with posterior subluxation of PIP joint.
Functional outcome following this procedure in both acute and chronic cases resulted in adequate restoration of joint stability and function.
Hemihamate arthroplasty is an adjuvant in the treatment of unstable intra-articular pilon fracture involving PIP joint.
近端指间关节骨折脱位后的损伤取决于力的传导方向以及撞击时关节的位置。伴有掌侧唇骨折的背侧脱位最为常见。稳定性程度直接由中节指骨掌侧唇受累程度决定。
采用半钩骨成形术对5例手指中节指骨近端粉碎性嵌插骨折进行重建。3例患者在伤后2周内就诊;1例患者伤后1个月就诊,另1例患者伤后3个月就诊。所有患者均表现为近端指间关节后脱位。
该手术在急性和慢性病例中的功能结局均使关节稳定性和功能得到充分恢复。
半钩骨成形术是治疗累及近端指间关节的不稳定关节内髁状骨折的一种辅助方法。