Morisawa Yasushi, Takayama Shinichiro, Sato Kazuki
‡ Departments of Orthopaedic Surgery, National Hospital Organization Saitama National Hospital, Saitama, Japan.
* Departments of Orthopaedic Surgery, National Center for Child Health and Development, Tokyo, Japan.
Hand Surg. 2015 Oct;20(3):471-3. doi: 10.1142/S0218810415720223.
A 13-year-old girl sustained epiphyseal fractures of the proximal phalanges of the left index, middle, and ring fingers. Though manual reduction of the 3 fingers was possible, it was difficult to maintain the reduction due to severe instability of the middle and ring fingers, and closed reduction with external fixation was performed. At 4 years post-injury, the patient had no impairment of daily activities. The use of external fixation (1) causes no injury to the epiphyseal cartilage, (2) enables accurate reduction and maintenance of reduction, (3) is technically easier than pinning, (4) enables earlier range of motion (ROM) exercises of the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints of the externally fixated and other fingers, and (5) allows repeated fine adjustments after reduction. External fixation is an option for the treatment of children with highly unstable epiphyseal fractures of the proximal phalanges.
一名13岁女孩的左手示指、中指和环指近节指骨发生骨骺骨折。虽然这3根手指能够进行手法复位，但由于中指和环指严重不稳定，难以维持复位，遂行闭合复位外固定术。伤后4年，患者日常生活活动无受限。外固定的优点包括：(1) 不损伤骨骺软骨；(2) 能够精确复位并维持复位效果；(3) 在技术操作上比穿针更容易；(4) 能使外固定手指及其他手指的近端指间关节（PIP）和远端指间关节（DIP）更早地进行活动度（ROM）练习；(5) 复位后允许反复进行微调。对于近端指骨骨骺骨折高度不稳定的儿童患者，外固定是一种治疗选择。
