Le Nen D
Service de chirurgie orthopédique et traumatologique, hôpital de la Cavale Blanche, CHU, rue Tanguy-Prigent, 29200 Brest, France.
Chir Main. 2014 Feb;33(1):1-12. doi: 10.1016/j.main.2013.08.007. Epub 2013 Dec 30.
Metacarpal and phalangeal fractures of the long fingers are the result of trauma occurring under extremely varied circumstances. As a consequence, the clinical presentation varies greatly, with every bone and joint potentially being involved. Each step of their treatment is crucial, although the benign appearance of these injuries can lead to steps being missed: diagnostic phase with clinical examination and radiographs; therapeutic phase where the most suitable treatment is chosen, which combines mobilization of the digital chains as soon as possible and in every patient; follow-up phase with regular monitoring to detect any complications, especially secondary displacement, and verify that good progress is being made during rehabilitation. The goal of any fracture treatment is to preserve or restore the anatomy, with the emphasis here being on the stability and mobility of the digital chains. The potential progression towards serious functional sequelae (pain, instability or stiffness in hand) and the resulting significant socio-economic repercussions must be at the forefront of a surgeon's mind early on during the initial care of any finger or hand trauma.
长手指的掌骨和指骨骨折是在极其多样的情况下发生创伤的结果。因此，临床表现差异很大，每块骨骼和关节都有可能受累。其治疗的每一个步骤都至关重要，尽管这些损伤看似不严重，但可能导致某些步骤被遗漏：包括临床检查和X光片的诊断阶段；治疗阶段，即选择最合适的治疗方法，该方法要尽快且适用于每位患者地结合手指链的活动；随访阶段，通过定期监测以发现任何并发症，尤其是二次移位，并核实康复过程进展良好。任何骨折治疗的目标都是保留或恢复解剖结构，这里重点在于手指链的稳定性和灵活性。在任何手指或手部创伤的初始治疗早期，外科医生必须尽早将可能发展为严重功能后遗症（手部疼痛、不稳定或僵硬）以及由此产生的重大社会经济影响牢记于心。
