Goorens Chul Ki, Van Hoonacker Petrus, Kerckhove Diederik, Berghs Bart, Goubau Jean
Department of Orthopaedic Surgery, AZ Sint-Jan, Brugge, Belgium.
Acta Orthop Belg. 2012 Aug;78(4):473-8.
Treatment of fractures of the proximal phalanx of the long fingers remains difficult and challenging ; several options have been used. We report our experience with an isometric traction splint, modified from the Southampton design. A cohort of 32 patients with displaced fractures of a proximal phalanx was treated and assessed retrospectively after a short term (9 weeks after splint application). Traction splint was applied to realign the fracture and to control rotation. This construct was used for approximatively 5 weeks (mean: 36 days; range: 21-44 days), considering the usual progression of fracture healing in closed phalangeal fractures and patient tolerance to the splint. Three weeks after splint removal, almost full range of motion was regained in the metacarpophalangeal and interphalangeal joints in all patients, except in 3 cases. Two of these three patients had a displaced fracture of the proximal phalanx as a result of a compression trauma. The combination of the trauma type with static traction splint led to a tenodesis effect with a severe active flexion deficit in the metacarpophalangeal and interphalangeal joints. Our results suggest that isometric traction splint is a valid treatment option for displaced fractures of the proximal phalanx, however compression type fractures should be excluded.
长手指近节指骨骨折的治疗仍然困难且具有挑战性；已经采用了多种治疗方法。我们报告了我们使用的一种根据南安普敦设计改良的等距牵引夹板的经验。回顾性地治疗并评估了一组32例近节指骨移位骨折患者，观察期为短期（应用夹板9周后）。应用牵引夹板使骨折复位并控制旋转。考虑到闭合性指骨骨折的骨折愈合通常进程以及患者对夹板的耐受性，该装置使用了约5周（平均：36天；范围：21 - 44天）。去除夹板3周后，除3例患者外，所有患者的掌指关节和指间关节几乎恢复了全部活动范围。这3例患者中有2例因挤压伤导致近节指骨移位骨折。创伤类型与静态牵引夹板的结合导致了一种关节固定效应，掌指关节和指间关节出现严重的主动屈曲功能障碍。我们的结果表明，等距牵引夹板是治疗近节指骨移位骨折的一种有效治疗选择，然而应排除挤压型骨折。
