Liodaki E, Xing S G, Mailaender P, Stang F
Department of Plastic, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Luebeck, Germany.
Department of Hand Surgery, Affiliated Hospital of Nantong University, Jiangsu, China.
J Hand Surg Eur Vol. 2015 Jan;40(1):16-23. doi: 10.1177/1753193414559464. Epub 2014 Nov 26.
Intra-articular fractures or fracture dislocations of the proximal interphalangeal joint are difficult clinically because the bone and soft tissue structures are small and intricate. Suboptimal treatment of intra-articular fractures typically leads to functional impairment of the hand. This article reviews the current methods of treatment, together with the senior author's experience in treating difficult proximal interphalangeal joint fractures and dislocations. Besides conservative treatments, surgical treatments include open or closed reduction with traditional Osteosynthesis, such as K-wires, screws or plates. Among recent developments are the percutaneous application of thin cannulated compression screws and novel dynamic external fixators. After a preferred minimally invasive treatment with stable reconstruction of the articular surface, sufficient aftercare is necessary to improve surgical outcomes.
近端指间关节的关节内骨折或骨折脱位在临床上处理起来较为困难，因为其骨骼和软组织结构细小且复杂。关节内骨折若治疗欠佳，通常会导致手部功能受损。本文回顾了当前的治疗方法，以及资深作者在处理复杂近端指间关节骨折和脱位方面的经验。除保守治疗外，手术治疗包括采用传统接骨术进行切开或闭合复位，如使用克氏针、螺钉或钢板。近期的进展包括经皮应用细空心加压螺钉和新型动力外固定器。在采用首选的微创治疗并稳定重建关节面后，充分的术后护理对于改善手术效果很有必要。
