Light T R, Ogden J A
Department of Orthopaedics and Rehabilitation, Loyola University School of Medicine, Maywood, Illinois.
J Pediatr Orthop. 1988 May-Jun;8(3):300-5. doi: 10.1097/01241398-198805000-00009.
Four cases of complex dislocation of the index metacarpophalangeal joint prior to skeletal maturity were reviewed. Despite the generalized laxity present in these children, none of the dislocations could be anatomically reduced by closed methods. Two patients had a concomitant osteochondral fracture from the ulnar side of the metacarpal epiphysis; one subsequently developed a lesion similar to an epiphyseal osteochondroma. One patient developed ischemic necrosis leading to premature growth arrest; a shortened metacarpal, and a deformed metacarpal head. The possibility of vascular damage must be considered in the skeletally immature patient, since the epiphyseal and physeal circulation may be compromised by either the dislocation or exposure for the reduction.
回顾了4例骨骼成熟前的示指掌指关节复杂脱位病例。尽管这些儿童普遍存在关节松弛，但通过闭合方法均无法实现解剖复位。2例患者伴有掌骨骨骺尺侧的骨软骨骨折；其中1例随后发展为类似骨骺骨软骨瘤的病变。1例患者发生缺血性坏死，导致过早生长停滞、掌骨缩短和掌骨头变形。对于骨骼未成熟的患者，必须考虑血管损伤的可能性，因为脱位或复位时的暴露都可能损害骨骺和骺板的血供。
