Frueh Florian S, Vogel Philippe, Honigmann Philipp
Hand Surgery, Kantonsspital Baselland, Liestal, Switzerland.
Department of Radiology, Kantonsspital Baselland, Liestal, Switzerland.
Plast Reconstr Surg Glob Open. 2018 May 18;6(5):e1729. doi: 10.1097/GOX.0000000000001729. eCollection 2018 May.
The "jammed finger" is among the most common hand injuries and may include simple sprains, dislocations, fractures, and fracture-dislocations. In contrast, irreducible dislocations of the proximal interphalangeal joint are rare injuries. However, they must not be overlooked in the primary assessment, because persistent subluxation may lead to joint contracture, severely compromising hand function. Irreducible dislocations are challenging injuries with interposed soft tissues, preventing closed reduction. Thorough preoperative diagnosis and soft-tissue imaging guide the approach to open reduction and repair of injured periarticular structures. We introduce a systematic algorithm with considerations on classification and management of irreducible proximal interphalangeal joint dislocations. The algorithm is useful for the primary assessment and for hand surgeons responsible for open reduction and rehabilitation.
“手指绞伤”是最常见的手部损伤之一，可能包括单纯扭伤、脱位、骨折以及骨折脱位。相比之下，近端指间关节不可复位性脱位是罕见的损伤。然而，在初步评估中绝不能忽视它们，因为持续的半脱位可能导致关节挛缩，严重损害手部功能。不可复位性脱位是伴有软组织嵌入的具有挑战性的损伤，妨碍闭合复位。全面的术前诊断和软组织成像可为开放性复位及修复受损关节周围结构的方法提供指导。我们引入一种系统算法，用于考虑近端指间关节不可复位性脱位的分类和处理。该算法对初步评估以及负责开放性复位和康复的手外科医生很有用。
