Cuénod P
CH8, centre de chirurgie & thérapie de la main, rue Charles-Humbert 8, PO box 5111, 1211 Genève 11, Suisse.
Chir Main. 2013 Oct;32(5):287-91. doi: 10.1016/j.main.2013.07.005. Epub 2013 Aug 12.
Middle phalanx neck fracture is an unusual injury. In order to prevent malunion and stiffness, a surgical treatment is usually recommended. Owing to the distal localization of the fracture, internal fixation is demanding. Open reduction can further damage the soft tissues and the bone itself, resulting in stiffness or condylar necrosis. The bulk of plate and screws can interfere with the extensor apparatus and transarticular or cross K-wires may damage the joint surfaces or ligaments. An intramedullary pinning technique is reported minimizing these pitfalls. The technique is described and illustrated by two clinical cases with good result.
中指近节指骨颈部骨折是一种不常见的损伤。为防止畸形愈合和关节僵硬,通常建议采取手术治疗。由于骨折部位靠近远端,内固定颇具挑战性。切开复位会进一步损伤软组织和骨骼本身,导致关节僵硬或髁突坏死。钢板和螺钉体积较大可能会干扰伸肌装置,而经关节或交叉克氏针可能会损伤关节面或韧带。据报道,髓内穿针技术可最大程度减少这些问题。本文通过两个临床病例对该技术进行了描述和说明,效果良好。