Micro external fixation device and arthrolysis for treatment of old proximal interphalangeal joint fracture with dorsal dislocation
Objective To evaluate the clinical efficacy of micro external fixation device and arthrolysis for treatment of old proximal interphalangeal joint fracture with dorsal dislocation.Methods From June 2013 to November 2016,11 cases of old proximal interphalangeal joint fracture with dorsal dislocation were treated by interphalangeal joint release combined with micro external fixation device.According to Schenck's classification,there were 4 cases of type Ⅰ A,2 cases of type Ⅰ B,and 5 cases of type Ⅱ B.The preoperative interphalangeal joint function was evaluated as poor according to the Ishida-Ikuta score.During the operation,the superficial flexor tendon of the finger was released and the proximal end of the volar plate was cut in a V-shape.The fracture end was freshened,and the interphalangeal joint was released to allow passive flexion and extension to reach the normal range.The fracture was reduced,and the volar plate and collateral ligament were repaired with tendon sutures.After fixing the fracture block,a micro external fixation device was used to retract and maintain the joint space.After 4 weeks of surgery,the external fixation device was removed and the active and passive flexion and extension exercise of the proximal interphalangeal joint began.The fracture healing was followed up after surgery and the function was evaluated using the Ishida-Ikuta score.Results All the patients received complete follow-up after surgery,ranging from 7 to 24 months,with an average of 13.1 months.The incisions achieved primary healing,and there were no complications such as finger nerve injury.Among them,one patient had a needle infection,which healed after removing the external fixation device and changing the dressing.The postoperative X-ray showed that all the fractures healed completely in all cases,with a time of 9 to 13 weeks,with an average of 10.3 weeks.According to Ishida-Ikuta score,the results were rated as excellent in 10 cases and good in 1 case.Conclusion The application of proximal interphalangeal joint release combined with micro external fixation device is effective in the treatment of old proximal interphalangeal joint fracture with dorsal dislocation.
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