Sakuma M, Nakamura R, Inoue G, Horii E
Department of Orthopaedic Surgery, Nagoya University School of Medicine, Japan.
J Hand Surg Br. 1997 Oct;22(5):667-71. doi: 10.1016/s0266-7681(97)80372-5.
Six patients with avulsion fractures of the metacarpophalangeal joints of the fingers are reported. Operation was performed in all cases. Judging from the operative findings, the radiological assessment of fragment shape is helpful in treatment. Surgery is recommended when the fragment is triangular or rectangular in shape because the fracture involves the articular surface. Conservative treatment is effective if the fragment is round because the articular surface of the joint is not involved in this type of fracture. The avulsed fragment often overlaps the metacarpal head and a collateral ligament injury is likely to be misdiagnosed. It is important to suspect this injury and assess the shape of the whole fragment for a good functional result.
本文报告了6例手指掌指关节撕脱性骨折患者。所有病例均接受了手术治疗。根据手术所见，骨折块形状的影像学评估对治疗有帮助。当骨折块呈三角形或矩形时建议手术，因为这种骨折累及关节面。如果骨折块呈圆形，保守治疗有效，因为这种类型的骨折不累及关节面。撕脱的骨折块常与掌骨头重叠，可能会误诊为侧副韧带损伤。怀疑有这种损伤并评估整个骨折块的形状对于获得良好的功能结果很重要。
