Lawson E, Thomsen L, Hans-Moevi Akué A, Falcone M-O
Centre SOS main de l'est parisien, clinique La Francilienne, 16, avenue de l'Hôtel-de-Ville, 77340 Pontault-Combault, France; Clinique universitaire de traumatologie-orthopédie et de chirurgie réparatrice, CNHU-HKM, Cotonou, Bénin.
Chir Main. 2013 Oct;32(5):281-6. doi: 10.1016/j.main.2013.07.008. Epub 2013 Aug 14.
The palmar fracture-dislocation of the proximal interphalangeal (PIP) joint of fingers is an uncommon injury. We report a complex form in a 16-year old teenager, associating a palmar fracture-dislocation and a fracture of the base of the middle phalanx with the dorsal fragment dislocated between the neck of the proximal phalange and the palmar plate. The management was surgical with open reduction and fixation of the fragments by K-wires and temporary PIP arthrorisis. The result at 6months of follow- up after removal of the wires and physiotherapy was satisfactory. The patient was painless with a range of motion of 115°. Clinically, the sagittal and frontal stability of the joint both in flexion and extension was maintained. Osseous healing was obtained on X-ray control. The patient went back to his usual activities. A focus on palmar fracture-dislocations of PIP joint is presented through incidence, mechanism and treatment.
手指近节指间关节（PIP）掌侧骨折脱位是一种少见的损伤。我们报告了一名16岁青少年的复杂病例，该病例合并掌侧骨折脱位及中节指骨基底部骨折，背侧骨折块脱位至近节指骨颈部与掌板之间。治疗采用手术切开复位，用克氏针固定骨折块，并临时进行PIP关节制动。取出克氏针并进行物理治疗后6个月的随访结果令人满意。患者无痛，活动范围达115°。临床上，关节在屈伸时的矢状面和额状面稳定性均得以维持。X线检查显示骨折已骨性愈合。患者恢复了日常活动。本文通过发病率、机制及治疗方法对PIP关节掌侧骨折脱位进行了重点阐述。
