Hara Akira, Yokoyama Minoru, Ichihara Satoshi, Maruyama Yuichiro
Department of Orthopedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan; Department of Orthopedic Surgery, Tanaka Neurosurgical Hospital, Tokyo, Japan.
Department of Orthopedic Surgery, Tanaka Neurosurgical Hospital, Tokyo, Japan.
Int J Surg Case Rep. 2020;68:12-17. doi: 10.1016/j.ijscr.2020.02.020. Epub 2020 Feb 13.
Comminuted fractures involving the articular surface of the base of the proximal phalanx are relatively rare. We treated a patient with this type of fracture by open reduction and internal fixation with a locked-wire-type external fixator (Ichi-Fixator System).
A 45-year-old man was injured because his ring finger was kicked during a Futsal game. Radiographs and computed tomography revealed a comminuted intraarticular fracture of the proximal phalanx of this ring finger. We treated the fracture with open reduction and K-wires and external fixation. We removed the K-wire and external fixator 5 weeks postoperatively and initiated range of motion exercises. Five months postoperatively, his finger motion was fully recovered without restriction.
Comminuted intraarticular fractures of the base of the proximal phalanx are usually treated with plating. Complications such as interference with excursion of the central slip and lateral bands, extensor tendon rupture, and plate prominence have been reported in these fractures. In our patient, the Ichi-Fixator System was useful as a distraction apparatus for metacarpophalangeal joint fixation.
A comminuted intra-articular fracture of the base of the proximal phalanx was treated successfully using the Ichi-Fixator system.
累及近节指骨基底关节面的粉碎性骨折相对少见。我们使用锁定钢丝式外固定器（市外固定器系统）对一名此类骨折患者进行了切开复位内固定治疗。
一名45岁男性在一场室内五人制足球比赛中因无名指被踢而受伤。X线片和计算机断层扫描显示该无名指近节指骨存在粉碎性关节内骨折。我们采用切开复位、克氏针及外固定治疗该骨折。术后5周取出克氏针和外固定器并开始进行活动度练习。术后5个月，其手指活动完全恢复且不受限。
近节指骨基底的粉碎性关节内骨折通常采用钢板固定治疗。这些骨折已报告出现如影响中央滑液和侧束活动、伸肌腱断裂及钢板突出等并发症。在我们的患者中，市外固定器系统作为掌指关节固定的牵引装置很有用。
使用市外固定器系统成功治疗了近节指骨基底的粉碎性关节内骨折。
