Mitz V, Hajeri A, Guelmi K, Lemerle J P
Service de Chirurgie Réparatrice SOS Mains Boucicaut, Hôpital Boucicaut, Paris.
Ann Chir Main. 1989;8(3):246-51. doi: 10.1016/s0753-9053(89)80062-6.
We advise dynamic extensor splintage put on as early as possible within the first 6 weeks after the diagnosis of boutonniere deformity. This splintage runs from the dorsal aspect of the hand to the DIP joint which is left free to flex actively. This apparatus is left on for at least six weeks post injury. Sixteen patients have been treated in this way. Seven of them were monitored carefully. Only one had a bad result with DIP flexion still preserved. The others averaged a mean extension loss of 23 degrees, and no loss of extension in DIP joints. Active flexion both in PIP and DIP was perfectly preserved. The functional treatment without surgery seems to be a good technique in management of fresh rupture of the extensor mechanism in PIP joints.
我们建议在纽扣畸形诊断后的头6周内尽早进行动态伸肌夹板固定。这种夹板从手背延伸至远端指间关节（DIP），该关节可主动自由屈曲。此器具在受伤后至少佩戴六周。已有16名患者接受了这种治疗方式。其中7名患者得到了密切监测。只有1例效果不佳，远端指间关节仍保留一定屈曲功能。其他患者平均伸直丧失23度，远端指间关节无伸直丧失。近端指间关节（PIP）和远端指间关节的主动屈曲功能均完全保留。对于近端指间关节伸肌机制新鲜断裂的处理，非手术的功能治疗似乎是一种不错的技术。
