Gaston R Glenn, Chadderdon Christopher
OrthoCarolina, 1915 Randolph Road Suite 200, Charlotte, NC 28207, USA.
Hand Clin. 2012 Aug;28(3):395-401, x. doi: 10.1016/j.hcl.2012.05.032. Epub 2012 Jun 26.
Nonsurgical management is the preferred treatment of stable, extra-articular fractures of the proximal and middle phalanx, most distal phalanx fractures, and, rarely, nondisplaced intraarticular fractures in elite athletes. Techniques that afford maximal strength with minimal dissection, thus allowing earlier return to play, are ideal. Open reduction with internal fixation with plate fixation is most often chosen for unstable phalangeal shaft fractures in high-demand athletes to provide rigid internal fixation and allow immediate range of motion and more rapid return to sport. It is our practice to routinely treat unicondylar fractures with surgery with percutaneous headless compression screws in elite athletes.
非手术治疗是近端和中节指骨稳定的关节外骨折、大多数远节指骨骨折以及精英运动员中极少的无移位关节内骨折的首选治疗方法。理想的技术是在最小限度剥离的情况下提供最大强度,从而允许更早重返比赛。对于高要求运动员的不稳定指骨干骨折,通常选择切开复位钢板内固定,以提供坚强的内固定,并允许立即进行活动范围训练和更快重返运动。我们的做法是,对于精英运动员的单髁骨折,常规采用经皮无头加压螺钉手术治疗。