Milner Chris, Samson Deepak, Tan Simon
1 Birmingham Hand Centre, Queen Elizabeth Hospital, Birmingham, UK.
J Hand Surg Asian Pac Vol. 2019 Mar;24(1):50-54. doi: 10.1142/S2424835519500097.
To evaluate the treatment of severe dorsal fracture dislocation (DFD) injuries of the proximal interphalangeal joint (PIPJ) by open reduction, bone grafting and fixation with mini-hook plates.
Fourteen patients with extensive dorsal fracture dislocation of the PIPJ were operatively treated to reconstruct the fractured middle phalanx volar lip using a fabricated hook plate in conjunction with elevation and bone grafting of depressed articular fragments where present.
Restoration of PIPJ articular anatomy and congruence by hook plate fixation permitted full-range mobilization of the joint during fracture healing, with an average arc of motion of 81° and an average loss of extension of 12.9° at a minimum of 6 months follow up. Hook plate treatment of PIPJ fracture dislocation restores articular anatomy and joint congruence at a single sitting and permits post-operative mobilization without the need for extension block splinting.
Our results demonstrate a good range of motion following treatment, however hardware removal and tenolysis was necessary in 36% of cases.
评估切开复位、植骨并用微型钩板固定治疗近端指间关节（PIPJ）严重背侧骨折脱位（DFD）损伤的效果。
对14例PIPJ广泛背侧骨折脱位患者进行手术治疗，使用预制钩板重建中节指骨掌侧唇骨折，并对存在的关节面塌陷骨折块进行抬高和植骨。
通过钩板固定恢复PIPJ关节解剖结构和一致性，使骨折愈合期间关节能够进行全范围活动，在至少6个月的随访中，平均活动弧度为81°，平均伸直丧失为12.9°。钩板治疗PIPJ骨折脱位可一次性恢复关节解剖结构和一致性，术后无需使用伸展阻挡夹板即可活动。
我们的结果表明治疗后活动范围良好，然而36%的病例需要取出内固定物和进行肌腱松解术。
