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微创矫正性截骨术联合伊里扎洛夫微型外固定器治疗指骨畸形愈合:技术说明。

Minimally Invasive Corrective Osteotomy with the Ilizarov Mini-Fixator for Malunited Fractures of the Phalanges: Technical Note.

机构信息

Department of Orthopedic Surgery, Nippon Medical School Hospital.

出版信息

J Nippon Med Sch. 2021 Jun 30;88(3):262-266. doi: 10.1272/jnms.JNMS.2021_88-314. Epub 2020 Aug 31.

Abstract

Posttraumatic malunion of the phalanx with rotational deformity may cause crossing of the finger and impair hand function. Cosmetic disfigurement and severe dysfunction of the fingers require surgical correction, most often via open corrective osteotomies and rigid fixation with plates. However, such an approach requires a longer incision, inevitably results in a scar, and has a higher potential for extensor tendon adhesions, which result in extension lags. In addition, abruption of the periosteum and plating of the phalanges require longer bone healing. This report describes the straightforward, minimally invasive correction of phalangeal malunions with a mini-external fixator. In this procedure, a digital block of the affected finger can be performed. The fully flexed position of all fingers provides accurate correction of phalangeal malunions. Although treatment of phalangeal malunions remains challenging, the present procedure is an alternative solution for phalangeal malunions.

摘要

末节骨创伤性愈合畸形伴旋转畸形可导致手指交叉,并影响手部功能。手指的美容畸形和严重功能障碍需要手术矫正,最常通过切开矫正截骨术和用钢板进行刚性固定来实现。然而,这种方法需要更长的切口,不可避免地会留下疤痕,并且有更高的伸肌腱粘连的风险,从而导致伸肌迟滞。此外,骨膜剥离和指骨钢板固定需要更长的骨愈合时间。本报告介绍了使用微型外固定器对末节骨畸形愈合进行简单、微创矫正的方法。在该手术中,可以对受影响的手指进行指神经阻滞。所有手指的完全弯曲位为末节骨畸形愈合的准确矫正提供了条件。尽管末节骨畸形愈合的治疗仍然具有挑战性,但目前的手术是治疗末节骨畸形愈合的另一种选择。

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