Kobayashi Koichi, Fukasawa Katsuyasu
Department of Orthopedic Surgery, Kanto Rosai Hospital, Kawasaki City 211-8510, Japan.
Hand Surg. 2014;19(3):455-7. doi: 10.1142/S0218810414720368.
We applied an adjustable traction method which enables early range of motion exercise for the dorsal fracture-dislocation of the distal interphalangeal joint, and obtained satisfactory results. The reduction of comminuted fragments or depression of the joint is unnecessary using the traction method, because early exercise accelerates the remodelling of the injured soft tissue, followed by the development of joint stability. This traction mechanism is independent of the vector force of the traction applied due to the frame-structure construction. Our method makes it easy to adjust the traction force in millimetre increments of the glove-finger length, and has broad range of traction force. In cases where the dislocation is persistent even after strengthening the traction force, a transverse-transfixing Kirschner wire (K-wire) can be inserted to hold the reduction securely against subluxation.
我们应用了一种可调节牵引方法，该方法能够使指间关节背侧骨折脱位进行早期活动度锻炼，并取得了满意的效果。使用该牵引方法时，无需复位粉碎性骨折块或关节凹陷，因为早期锻炼可加速受损软组织的重塑，进而增强关节稳定性。由于采用框架结构设计，这种牵引机制独立于所施加牵引的矢量力。我们的方法能够轻松地以手套手指长度的毫米增量来调节牵引力，并且具有广泛的牵引力范围。在即使增强牵引力后脱位仍持续存在的情况下，可以插入一根横向固定克氏针来牢固维持复位，防止半脱位。
