Florek Jakub, Georgiew Filip, Petrovych Oles
Department of Orthopedics and Traumatology, Rydygier Hospital, Brzesko, POL.
Faculty of Health Science, University of Applied Sciences, Tarnów, POL.
Cureus. 2024 Jul 25;16(7):e65326. doi: 10.7759/cureus.65326. eCollection 2024 Jul.
Fractures of the proximal interphalangeal (PIP) joint with fragment displacement should be promptly repaired after injury, though this does not ensure the return of pre-injury finger function. This article presents the case of a 29-year-old patient who sustained an injury to the fourth finger of his right hand, resulting in an open fracture of the distal and shaft of the proximal phalanx involving the PIP joint and partial damage to the finger extensor mechanism. Immediately post injury, the fracture was realigned and stabilized with Kirschner wires (K-wires). Three years later, due to post-traumatic degenerative disease, the patient required further surgical intervention and was diagnosed with type III according to the modified Kellgren and Lawrence scale. The decision was made to perform a partial arthroplasty of the PIP joint. The implantation of the PIP prosthesis in a patient with post-traumatic degenerative disease can restore the correct range of flexion movement, realign the fourth digit, and eliminate pain. However, this treatment method may pose a risk of a slight limitation in the range of extension motion in the joint.
近端指间（PIP）关节骨折伴骨折块移位者，伤后应及时修复，尽管这并不能确保伤前手指功能的恢复。本文介绍了一名29岁患者的病例，其右手第四指受伤，导致近节指骨远端和骨干开放性骨折，累及PIP关节，手指伸肌机制部分受损。受伤后立即用克氏针（K线）对骨折进行复位和固定。三年后，由于创伤后退行性疾病，患者需要进一步手术干预，并根据改良的凯尔格伦和劳伦斯量表被诊断为III型。决定对PIP关节进行部分关节成形术。在创伤后退行性疾病患者中植入PIP假体可以恢复正确的屈曲运动范围，使第四指重新对线，并消除疼痛。然而，这种治疗方法可能会有导致关节伸展运动范围略有受限的风险。
