革新近端指间关节骨折治疗:一例手术精准与快速康复的病例

Revolutionizing PIP joint fracture treatment: A case of surgical precision and rapid recovery.

作者信息

Pantaleoni Filippo, Boccolari Paolo, Tedeschi Roberto, Donati Danilo

机构信息

Department of Hand surgery and Microsurgery, University Hospital of Modena, Modena, Italy.

University of Modena and Reggio Emilia, Largo del Pozzo 71, 41124 Modena, Italy.

出版信息

Int J Surg Case Rep. 2024 Jul;120:109813. doi: 10.1016/j.ijscr.2024.109813. Epub 2024 May 28.

Abstract

INTRODUCTION

Proximal interphalangeal joint (PIPj) fractures are a common yet challenging injury, particularly in athletes. This case study explores innovative surgical techniques combined with targeted rehabilitation to optimize recovery and functionality.

CASE PRESENTATION

A 20-year-old male soccer goalkeeper sustained a severe Proximal Interphalangeal Joint fracture-dislocation of the third finger during a game. He was treated using the wide awake local anesthesia no tourniquet (WALANT) technique and a Medartis TriLock plate, originally designed for the proximal phalanx but adapted for use on the middle phalanx.

CLINICAL DISCUSSION

Immediate postoperative mobilization was facilitated by the WALANT technique, enhancing pain management and functional recovery. The adaptation of the TriLock plate, typically not used in this context, proved crucial for stabilizing the complex fracture. Follow-up included regular physiotherapy, focusing on mobility exercises and strength training, which were instrumental in the patient's quick return to sport.

CONCLUSIONS

This case underscores the effectiveness of combining innovative surgical adaptations with early rehabilitation in treating complex hand injuries. Such approaches can lead to successful outcomes, significantly improving recovery times and functional results in athletic populations. This strategy may set a precedent for future treatment protocols in sports-related hand injuries.

摘要

引言

近端指间关节(PIPj)骨折是一种常见但具有挑战性的损伤,尤其是在运动员中。本病例研究探讨了创新的手术技术与针对性康复相结合,以优化恢复和功能。

病例介绍

一名20岁的男性足球守门员在一场比赛中遭受了严重的第三指近端指间关节骨折脱位。他采用清醒局部麻醉无止血带(WALANT)技术和Medartis TriLock钢板进行治疗,该钢板最初设计用于近端指骨,但经过改装用于中指骨。

临床讨论

WALANT技术有助于术后立即进行活动,加强了疼痛管理和功能恢复。通常在此情况下不使用的TriLock钢板的改装,被证明对稳定复杂骨折至关重要。随访包括定期物理治疗,重点是活动度练习和力量训练,这对患者快速重返运动起到了重要作用。

结论

本病例强调了将创新的手术改装与早期康复相结合治疗复杂手部损伤的有效性。这种方法可以带来成功的结果,显著缩短运动员群体的恢复时间并改善功能结果。这一策略可能为未来与运动相关的手部损伤治疗方案树立先例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a221/11214473/e631b3d9666b/gr1.jpg

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