Ozer Kagan
Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI.
J Hand Surg Am. 2019 Jun;44(6):524.e1-524.e6. doi: 10.1016/j.jhsa.2018.11.018. Epub 2019 Jan 23.
Pilon fractures of the proximal interphalangeal (PIP) joint are challenging injuries that can lead to arthritis, limited motion, and pain. Internal fixation is often difficult owing to comminution and inadequate bony support. External fixation requires a compliant patient and may result in pin-track infection, stiffness, and malunion. In this report, I describe a simple surgical technique of immediate bridge plating of the PIP joint with bone grafting followed by plate removal and joint release. This approach maintains the alignment, restores the articular congruity without the risk of pin-track infection, and allows immediate return to activities of daily living until fracture healing is completed.
近端指间关节（PIP）的Pilon骨折是具有挑战性的损伤，可导致关节炎、活动受限和疼痛。由于粉碎和骨支撑不足，内固定往往困难。外固定需要患者配合，且可能导致针道感染、僵硬和畸形愈合。在本报告中，我描述了一种简单的手术技术，即对PIP关节立即进行桥接钢板固定并植骨，随后取出钢板并松解关节。这种方法可维持对线，恢复关节一致性，且无针道感染风险，并允许在骨折愈合完成前立即恢复日常生活活动。
