钩板内固定治疗掌侧骨折近端咽间关节脱位的疗效分析。

IF 2.1 2区 医学 Q2 ORTHOPEDICS Journal of Hand Surgery-American Volume Pub Date : 2025-03-01 DOI:10.1016/j.jhsa.2023.09.004
Tatsuya Hara PhD , Toshikazu Kurahashi PhD , Yutaro Kuwahara MD , Masahiro Tatebe PhD , Takeshi Oguchi PhD , Shrio Urata MD
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引用次数: 0

摘要

目的:本研究旨在介绍背侧钢板技术治疗近端指间关节掌侧骨折脱位的临床结果。这种电镀技术最大限度地减少了手指伸肌机构的剥离和干扰。方法:在2018年4月至2022年8月期间,我们用背钩钢板治疗了7例PIP关节掌侧骨折脱位患者(平均年龄39.1岁)。5名患者的小指受到影响,2名患者的无名指受到影响。平均手术时间为5.6天,术后随访时间为7个月。术后第二天,所有患者均允许PIP和远端指间关节(DIP)活动。同时,开始DIP阻断运动,以防止伸肌机制粘连。结果:PIP关节的平均主动屈曲和伸展分别为105°和-4°,而DIP关节的平均活动屈曲和伸展为65°和4°。没有患者出现DIP关节的伸展滞后。平均总活动度(TAM)为273°,%TAM为96%。受影响手的握力平均为未受影响手握力的90%。疼痛的平均数字评分为0.3分,Hand20的平均得分为5.1分。未观察到并发症;两名患者应他们的要求接受了移植物手术。结论:本研究表明,这种钩板技术最大限度地减少了对手指伸展机制的干扰,是一种有效的手术方法,使患者能够耐受早期的运动范围锻炼,并在PIP和DIP关节中获得令人满意的临床结果。研究类型/证据水平:治疗性V。
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The Results of Hook Plate Fixation for Palmar Fracture Dislocation of the Proximal Interphalangeal Joint

Purpose

This study aimed to present the clinical outcomes of the dorsal plating technique for palmar fracture dislocations of the proximal interphalangeal (PIP) joint. This plating technique minimizes dissection and interference with the finger extensor mechanism.

Methods

We treated seven patients (with a mean age of 39.1 years) with dorsal hook plates for palmar fracture dislocations of the PIP joint between April 2018 and August 2022. The little finger was affected in five patients, and ring finger was affected in two. The mean time to surgery was 5.6 days, and the postoperative follow-up period was seven months. On the second postoperative day, all patients were allowed active motion of both the PIP and the distal interphalangeal (DIP) joints. Simultaneously, DIP blocking exercises were started to prevent adhesion of the extensor mechanism.

Results

The mean active flexion and extension of the PIP joint was 105° and −4°, respectively, whereas those of the DIP joint were 65° and 4°. No patient experienced extension lag in the DIP joint. The mean total active motion (TAM) was 273°, and the %TAM was 96%. The grip strength of the affected hand averaged 90% of that of the unaffected hand. The mean numerical rating scale for pain was 0.3 points, and the mean Hand20 score was 5.1 points. No complications were observed; two patients underwent implant removal at their request.

Conclusions

The present study suggests that this hook plate technique, which minimizes interference with the finger extension mechanism, is an effective surgical procedure that allows patients to tolerate early range of motion exercises and obtain satisfactory clinical outcomes in both the PIP and DIP joints.

Type of study/level of evidence

Therapeutic V.
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来源期刊
CiteScore
3.20
自引率
10.50%
发文量
402
审稿时长
12 weeks
期刊介绍: The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.
期刊最新文献
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