Barry K, McGee H, Curtin J
Cork Regional Hospital, Eire.
J Hand Surg Br. 1988 Nov;13(4):466-8. doi: 10.1016/0266-7681_88_90182-9.
Complex dislocation of the index metacarpo-phalangeal joint almost always requires surgical intervention. Controversy exists as to the most suitable surgical approach to reduction: palmar or dorsal. We reviewed four cases and carried out dissections in eight cadaver hands to compare the surgical approaches. The interposed volar plate was found to be the most important obstacle to reduction. Both approaches were successful in obtaining reduction. The dorsal approach was simple and safe, but necessitated longitudinal division of the volar plate and may carry a theoretical risk of late instability. The palmar approach allows restoration of normal anatomy but the radial neurovascular bundle is always vulnerable.
示指掌指关节的复杂脱位几乎总是需要手术干预。关于最适合复位的手术入路存在争议：掌侧还是背侧。我们回顾了4例病例，并在8具尸体手上进行解剖以比较手术入路。发现掌侧板嵌入是复位的最重要障碍。两种入路均成功实现了复位。背侧入路简单安全，但需要纵向切开掌侧板，理论上可能存在后期不稳定的风险。掌侧入路可恢复正常解剖结构，但桡神经血管束始终易受损伤。
