Department of Orthopedic Surgery, Nippon Medical School Hospital.
J Nippon Med Sch. 2023;90(2):141-148. doi: 10.1272/jnms.JNMS.2023_90-214.
Posttraumatic malunion with combination of angular, rotational, and shortening deformity of the proximal phalanx may cause scissoring of a finger and impairment of hand function. Cosmetic disfigurement and severe dysfunction of fingers require surgical correction, most often via open corrective osteotomies and rigid fixation with a plate or screws. However, such an approach requires a longer incision, inevitably results in a scar, and has a higher potential for extensor tendon adhesion. Also, abruption of the periosteum and plating of the phalange requires longer bone healing time. Thus, we devised a technique of minimally invasive correction of phalangeal malunion using an external mini-fixator. We presented representative three cases of malunited fractures of phalanges treated with the Ilizarov mini-fixator in adolescence and review reports of similar cases. The usage of Ilizarov mini-fixator provided excellent outcomes for posttraumatic malunion of three fingers.
创伤后畸形愈合可导致近节指骨成角、旋转和缩短畸形，从而导致手指交叉和手部功能障碍。手指的美容畸形和严重功能障碍需要手术矫正，最常见的方法是通过切开矫正截骨术和用钢板或螺钉进行刚性固定。然而，这种方法需要更长的切口，不可避免地会留下疤痕，并且伸肌腱粘连的可能性更高。此外，骨膜剥离和指骨钢板固定需要更长的骨愈合时间。因此，我们设计了一种使用外部微型固定器微创矫正指骨畸形的技术。我们介绍了使用伊里扎洛夫微型固定器治疗青少年时期畸形愈合的三个代表性的掌骨骨折病例，并回顾了类似病例的报告。伊里扎洛夫微型固定器的使用为三个手指的创伤后畸形愈合提供了极好的结果。
