Waters P M, Benson L S
Department of Orthopaedic Surgery, Harvard Medical School, Children's Hospital Medical Center, Boston, Mass.
J Hand Surg Am. 1993 Jul;18(4):581-5. doi: 10.1016/0363-5023(93)90293-C.
Two cases of physeal fracture dislocation of the distal phalanx are reviewed. Each injury occurred in a toddler, was originally undiagnosed, and appeared years later as a dorsal mass in a fore-shortened digit with decreased distal interphalangeal joint motion. In each case x-ray films revealed a dislocated epiphysis, accounting for the enlarging dorsal prominence and the phalangeal growth disturbance. These cases demonstrate that dislocation of the distal phalanx epiphysis can occur with a crush injury and may be difficult to detect before development of the ossification center. Careful physical examination and a high index of suspicion will increase the likelihood of early diagnosis. Early open reduction may prevent the late complications of deformity and stiffness.
回顾了两例末节指骨骨骺骨折脱位的病例。每例损伤均发生在幼儿期，最初未被诊断出来，多年后表现为手指背侧肿物，手指缩短，远侧指间关节活动度降低。在每例病例中，X线片显示骨骺脱位，这解释了背侧隆起增大和指骨生长紊乱的原因。这些病例表明，末节指骨骨骺脱位可由挤压伤引起，在骨化中心形成之前可能难以检测到。仔细的体格检查和高度的怀疑意识将增加早期诊断的可能性。早期切开复位可预防畸形和僵硬等晚期并发症。
