Lögters Tim T, Lee Hannah H, Gehrmann Sebastian, Windolf Joachim, Kaufmann Robert A
1 University Clinic Düsseldorf, Germany.
2 University of Pittsburgh Medical Center, PA, USA.
Hand (N Y). 2018 Jul;13(4):376-383. doi: 10.1177/1558944717735947. Epub 2017 Oct 27.
The goal of proximal phalangeal fracture management is to allow for fracture healing to occur in acceptable alignment while maintaining gliding motion of the extensor and flexor tendons.
We reviewed the most current literature on various treatment methods of proximal phalanx fractures, focusing on the indications and outcomes of nonoperative as well as operative interventions.
Stable fractures can be successfully treated nonoperatively, whereas unstable injuries benefit from surgery. Regardless of the surgical intervention employed, the overriding goal is to restore anatomy and impart enough stability to allow for early motion. The surgical dissection contributes to soft tissue scarring and should be minimized.
Clinical success is achieved when acceptable fracture alignment and stability occur in the setting of unobstructed tendon gliding and early active range of motion.
近端指骨骨折治疗的目标是在保持伸肌腱和屈肌腱滑动的同时,使骨折以可接受的对线方式愈合。
我们回顾了关于近端指骨骨折各种治疗方法的最新文献,重点关注非手术及手术干预的适应证和结果。
稳定骨折可通过非手术成功治疗,而不稳定损伤则从手术中获益。无论采用何种手术干预,首要目标是恢复解剖结构并给予足够稳定性以允许早期活动。手术解剖会导致软组织瘢痕形成,应尽量减少。
当骨折对线和稳定性可接受,同时肌腱滑动不受阻碍且早期活动范围正常时,临床治疗即取得成功。