指骨颈骨折复位或固定过程中造成的医源性指骨头粉碎。
Iatrogenic comminution of the phalangeal head during reduction or fixation of phalangeal neck fractures.
作者信息
Al-Qattan Mohammad M
机构信息
Department of Surgery, King Saud University, Riyadh, Saudi Arabia.
出版信息
Can J Plast Surg. 2012 Winter;20(4):233-6. doi: 10.1177/229255031202000408.
INTRODUCTION
Iatrogenic comminution of the phalangeal head during management of phalangeal neck fractures has not been previously investigated.
OBJECTIVE
To investigate the causes and outcomes of this particular iatrogenic complication.
METHODS
A database of phalangeal neck fractures over a six-year period (2006 to 2011) was reviewed for this iatrogenic complication. Special attention was devoted to documenting the cause and pattern of comminution of the phalangeal head, as well as the outcome in range of motion.
RESULTS
Of 152 cases treated during the study period, there were five (two children and three adults) with comminution. Two patterns of comminution were encountered: splitting and fragmentation of the phalangeal head. The complication occurred during open reduction and K-wire fixation, or during closed reduction in the emergency room. The outcome was generally poor and worse in patients with fragmentation of the entire head. Two of the five cases ultimately resulted in medicolegal claims.
CONCLUSION
Comminution of the phalangeal head is a serious iatrogenic complication that may occur during the management of phalangeal neck fractures. Awareness of this complication is important and attempts should be made to avoid it.
引言
指骨颈骨折治疗过程中发生的医源性指骨头粉碎此前尚未得到研究。
目的
探讨这一特定医源性并发症的原因及后果。
方法
回顾了一个为期六年（2006年至2011年）的指骨颈骨折数据库，以查找这一医源性并发症。特别关注记录指骨头粉碎的原因和类型，以及活动范围的结果。
结果
在研究期间治疗的152例病例中，有5例（2名儿童和3名成人）发生了粉碎。发现了两种粉碎类型：指骨头劈裂和碎裂。该并发症发生于切开复位和克氏针固定期间，或在急诊室进行闭合复位期间。总体结果较差，全头碎裂的患者情况更糟。5例中有2例最终导致医疗法律索赔。
结论
指骨头粉碎是指骨颈骨折治疗过程中可能发生的一种严重医源性并发症。认识到这一并发症很重要，应努力避免其发生。
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