Moradi A, Braun Y, Oflazoglu K, Meijs T, Ring D, Chen N
1 Orthopedic Hand and Upper Extremity Service, Massachusetts General Hospital - Harvard Medical School, Boston, MA, USA.
2 Orthopedics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
J Hand Surg Eur Vol. 2017 Feb;42(2):176-181. doi: 10.1177/1753193416669929. Epub 2016 Oct 3.
Radiographs and medical record of all adult patients with a mallet fracture in three hospitals between 2004 and 2014 were reviewed. International Classification of Diseases, Ninth Revision (ICD-9) codes and text search in radiographic reports were used to identify all acute patients with potential mallet fractures in our institutional database. Manually checking, 392 true mallet fractures were identified among them, 78 had subluxation at the time of diagnosis and 19 had subluxation at a later time point during treatment. Fragment size, fragment displacement, and interval between injury and treatment were associated with initial and late subluxation. Subluxation was not observed when the fracture size was less than 39% of the total articular surface. For each 1% increase in total articular surface involvement in fractures with more than 39% involvement, the risk of subluxation increased by 4% and for each 1% of displacement, the risk of subluxation increased by 4%.
IV.
回顾了2004年至2014年间三家医院所有成人锤状指骨折患者的X线片和病历。使用国际疾病分类第九版（ICD-9）编码并在X线片报告中进行文本搜索，以在我们的机构数据库中识别所有可能患有锤状指骨折的急性患者。经人工检查，其中共识别出392例真性锤状指骨折，78例在诊断时存在半脱位，19例在治疗过程中的后续时间点出现半脱位。骨折块大小、骨折块移位以及受伤与治疗之间的间隔与初始和晚期半脱位相关。当骨折块大小小于关节面总面积的39%时，未观察到半脱位。对于关节面受累超过39%的骨折，关节面受累每增加1%，半脱位风险增加4%；对于每1%的移位，半脱位风险增加4%。
IV级。
