Meyn M A
Clin Orthop Relat Res. 1981 Jul-Aug(158):215-8.
Volar dislocations of the proximointerphalangeal joint are not injuries to be treated lightly. If the dislocation reduces easily, a tear of the central tendon would be indicated and immediate open repair of this structure then becomes mandatory. If the dislocation is irreducible, then a tear of the collateral ligament with button-holing of the head of the proximal phalanx through the interval between the central tendon and the lateral band should be suspected, and open reduction and replacement of these structures in their normal position is indicated. The results after open repair of irreducible dislocations may be more favorable than dislocations that reduce easily. The extensor mechanism is intact and as the joint need not be held for long periods of time, motion can be started early and stiffness avoided.
近节指间关节掌侧脱位不可轻视。若脱位易于复位，提示中央腱撕裂，此时必须立即对该结构进行切开修复。若脱位无法复位，则应怀疑侧副韧带撕裂，近端指骨头通过中央腱与外侧束之间的间隙穿出形成纽扣样畸形，需切开复位并将这些结构恢复至正常位置。切开修复不可复位脱位后的效果可能比易于复位的脱位更好。伸肌机制完好，由于关节无需长时间固定，可早期开始活动并避免僵硬。
