Byrne Brent, Jacques Angela, Gurfinkel Reuven
Department of Occupational Therapy, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
Institute for Health Research, University of Notre Dame, Perth, Western Australia, Australia.
J Hand Surg Eur Vol. 2020 Feb;45(2):126-130. doi: 10.1177/1753193419881086. Epub 2019 Oct 22.
We performed a prospective, observational study using a non-surgical, conservative protocol with immediate mobilization for the treatment of 101 isolated stable or initially unstable proximal phalangeal fractures. The patients were evaluated at the time of discharge from therapy treatment, mean 7 weeks (range 3-15) after conservative treatment. These patients achieved a median proximal interphalangeal joint extension of -4° (IQR 0, -8), a mean total active motion of 253° (SD 20) and minimal pain. We conclude that a non-surgical, conservative protocol can be used for patients with isolated proximal phalangeal fractures without uncorrectable finger rotation or fracture angulation exceeding 25° in the sagittal plane or 10° in the coronal plane following closed reduction. Our data supports that a conservative protocol can be the good option for isolated stable or initially unstable proximal phalangeal fractures. IV.
我们采用非手术的保守方案并立即进行活动,对101例孤立的稳定型或初始不稳定型近端指骨骨折患者进行了一项前瞻性观察研究。在保守治疗后平均7周(范围3 - 15周)的治疗出院时对患者进行评估。这些患者近端指间关节伸展的中位数为-4°(四分位距0,-8),总主动活动度平均为253°(标准差20),且疼痛轻微。我们得出结论,对于闭合复位后无不可纠正的手指旋转或骨折成角超过矢状面25°或冠状面10°的孤立近端指骨骨折患者,可采用非手术的保守方案。我们的数据支持保守方案对于孤立的稳定型或初始不稳定型近端指骨骨折可能是一个不错的选择。 四、