Rayan G M, Mullins P T
J Hand Surg Am. 1987 Jul;12(4):548-52. doi: 10.1016/s0363-5023(87)80206-x.
Two patients are reported with full-thickness skin necrosis over the dorsum of the distal interphalangeal (DIP) joints after dorsal splint immobilization in hyperextension to treat acute mallet finger. An investigation was carried out to study the relationship of hyperextension to the dorsal circulation of the DIP joint. In 66 digits, the average degree of DIP joint hyperextension at which the skin blanches was 50% of the total passive hyperextension. It is recommended, therefore, when the DIP joint is immobilized to treat acute mallet finger, the degree at which the dorsal skin begins to blanch must be determined, and the amount of hyperextension should not exceed that degree. Excessive localized pressure to the dorsal skin should be avoided by adjusting the angle of the dorsal splint.
报告了两例在伸直位背侧夹板固定治疗急性锤状指后，远侧指间关节（DIP）背侧出现全层皮肤坏死的病例。开展了一项研究以探讨伸直位与DIP关节背侧血液循环之间的关系。在66个手指中，皮肤出现苍白时DIP关节伸直的平均程度为被动伸直总角度的50%。因此，建议在固定DIP关节治疗急性锤状指时，必须确定背侧皮肤开始出现苍白时的伸直程度，伸直程度不应超过该度数。应通过调整背侧夹板的角度，避免对背侧皮肤施加过大的局部压力。
