Chadaev A P, Butkevich A Ts, Emkuzhev V M
Khirurgiia (Mosk). 1995(2):38-9.
The results of treatment of 46 patients with purulent contused wounds in the region of the metacarpophalangeal joints are analysed. Damage to the articular capsule with development of arthritis occurred in 10 and damage to the capsule with osteoarthritis of the metacarpophalangeal joint in 18 patients. In 18 patients the joint was not involved in the pathological process. The treatment of such injuries consists in surgical debridement of the wound and obligatory inspection of the capsule of the underlying joint. If the articular capsule is damaged, drainage of the joint with installation of a drainage-irrigation system is performed and a primary suture is applied to the wound. If osteodestructive changes are found, sequestrectomy and drainage of the joint and wound is undertaken and a destruction apparatus is applied. It is emphasized that only timely surgical debridement of the purulent contused wound with inspection of the articular capsule guarantees successful treatment of this pathological condition.
对46例掌指关节区域脓性挫伤伤口的治疗结果进行了分析。10例出现关节囊损伤并发展为关节炎,18例出现掌指关节囊损伤并伴有骨关节炎。18例患者的关节未参与病理过程。此类损伤的治疗包括伤口的外科清创以及对深部关节囊的必要检查。如果关节囊受损,则进行关节引流并安装引流冲洗系统,同时对伤口进行一期缝合。如果发现骨质破坏改变,则进行死骨切除术、关节和伤口引流,并应用固定装置。强调只有及时对脓性挫伤伤口进行外科清创并检查关节囊,才能保证成功治疗这种病理状况。