Gonzalez M H, Igram C M, Hall R F
Department of Orthopaedics, University of Illinois, Chicago 60612-7342, USA.
J Hand Surg Am. 1995 Sep;20(5):808-12. doi: 10.1016/S0363-5023(05)80436-8.
A retrospective review of 25 consecutive patients with 28 proximal phalangeal fractures was performed. Fractures of the thumb were excluded. Twenty-five fractures were closed and three were open. All fractures were reduced, closed, and fixed using flexible intramedullary fixation with 0.8-mm prebent nails. Fractures amenable to flexible intramedullary fixation include short oblique and transverse fractures. Contraindications include long oblique, spiral, and bicortical comminuted fractures. The average follow-up time was 10 months (range, 2-20). Five patients with six fractures were lost to follow-up evaluation. All of the remaining 23 fractures healed and there were no infections. An average of 2 degrees angulation was seen on anteroposterior x-ray films. One patient showed 4 degrees of angulation on the lateral x-ray film. No shortening was noted. One fracture showed appreciable malrotation of 10 degrees. Flexible intramedullary rodding of specific proximal phalangeal fractures provides excellent results with a low complication rate. Proper selection of fractures and good surgical technique are necessary to avoid complications.
对连续25例患有28处近节指骨骨折的患者进行了回顾性研究。拇指骨折被排除在外。25处骨折为闭合性骨折，3处为开放性骨折。所有骨折均采用0.8毫米预弯髓内钉进行闭合复位和弹性髓内固定。适合弹性髓内固定的骨折包括短斜形和横形骨折。禁忌症包括长斜形、螺旋形和双皮质粉碎性骨折。平均随访时间为10个月（范围为2 - 20个月）。5例患者的6处骨折失访。其余23处骨折均愈合，且无感染发生。前后位X线片上平均成角2度。1例患者在侧位X线片上显示成角4度。未发现短缩情况。1处骨折出现了10度的明显旋转畸形。特定近节指骨骨折的弹性髓内棒固定效果良好，并发症发生率低。正确选择骨折类型和良好的手术技术对于避免并发症是必要的。
