Wu Caroline, Drake Matthew, Means Kenneth R
Georgetown University School of Medicine, Washington, DC.
The Department of Orthopedic Surgery and Sports Medicine, The University of Kansas, Lawrence, KS.
J Hand Surg Glob Online. 2022 Mar 3;4(3):189-193. doi: 10.1016/j.jhsg.2022.02.002. eCollection 2022 May.
A 28-year-old female recreational athlete presented with middle finger proximal interphalangeal joint pain, stiffness, and ulnar deviation deformity 2 years after internal fixation of a middle phalanx base fracture-dislocation. Radiographs revealed posttraumatic changes on both sides of the proximal interphalangeal joint. Having failed nonsurgical measures, she elected to proceed with surgical reconstruction. Intraoperatively, we confirmed substantial articular damage on both sides of the joint. We proceeded with hemi-hamate autograft for 80% of the middle phalanx base. We used a cobalt chrome proximal phalanx component. After healing, the patient returned to all daily-living and athletic activities with resolution of preoperative pain, stiffness, and deformity. Twelve years after surgey, she had no pain or substantial limitations because of the finger. We measured 80° of proximal interphalangeal joint motion. The grip and fingertip-pinch strength were 91% and 73%, respectively, of the contralateral dominant hand. Radiographs showed no progressive changes compared to 3 years after surgery.
一名28岁的女性业余运动员，在中指近节指骨基底部骨折脱位内固定术后2年，出现中指近端指间关节疼痛、僵硬和尺侧偏斜畸形。X线片显示近端指间关节两侧有创伤后改变。非手术治疗无效后，她选择进行手术重建。术中，我们证实关节两侧存在严重的关节损伤。我们用半块自体钩骨移植修复了80%的中指近节指骨基底部。我们使用了一个钴铬合金近端指骨部件。愈合后，患者恢复了所有日常生活和体育活动，术前的疼痛、僵硬和畸形均得到缓解。手术12年后，她的手指没有疼痛或明显功能受限。我们测量到近端指间关节活动度为80°。握力和指尖捏力分别为对侧优势手的91%和73%。与术后3年相比，X线片显示无进展性改变。
