Varadha Rajan Ashwini, Varadharajan Vigneswaran, Bhardwaj Praveen, Sabapathy S Raja
The Department of Plastic, Hand and Reconstructive Microsurgery, Ganga Medical Center and Hospitals, Coimbatore, Tamil Nadu, India.
Indian J Plast Surg. 2024 Jul 2;57(Suppl 1):S123-S127. doi: 10.1055/s-0044-1787849. eCollection 2024 Dec.
While proximal phalangeal joint injuries with comminution of the base of the middle phalanx are common injuries, proximal interphalangeal (PIP) joint fracture dislocations with an intact base of middle phalanx and a comminuted head of proximal phalanx are rare. Volar plate arthroplasty and other described techniques prevail for the former injury, while the latter does not have any supportive literature on the exact method of management. We herein present a 20-year-old male with a severely comminuted head of proximal phalanx fracture with dislocation of the PIP joint, which was not reconstructable but was managed successfully with a novel technique of volar plate draping that resurfaced the raw phalangeal head. A 3-year follow-up of the patient, whose finger has full, painless, and complete functional range of movement, gives us the belief that this procedure can provide a fully functional finger where other methods fail to do so.
虽然伴有中节指骨基部粉碎的近节指骨间关节损伤是常见损伤,但中节指骨基部完整且近节指骨头粉碎的近侧指间(PIP)关节骨折脱位却很罕见。掌侧板置换术及其他已描述的技术常用于前一种损伤,而对于后一种损伤,尚无关于确切治疗方法的支持性文献。我们在此报告一名20岁男性,其近节指骨头严重粉碎性骨折伴PIP关节脱位,无法进行重建,但采用一种新颖的掌侧板覆盖技术成功治疗,该技术使粗糙的指骨头重新表面化。对该患者进行3年随访,其手指具有完全、无痛且完整的活动功能范围,这使我们相信,在其他方法无效时,此手术可使手指恢复完全功能。