Journal of the Korean Orthopaedic Association (대한정형외과학회지)

Korean Orthopaedic Association (대한정형외과학회)
권호 표지
DOI QR코드

DOI QR Code

The Current Concepts in Treatment of Fracture-Dislocations of the Finger

수지 골절-탈구 치료의 최신 지견

  • Kang, Ho Jung (Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Ji Sup (Department of Orthopaedic Surgery, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine)
  • 강호정 (연세대학교 의과대학 강남세브란스병원 정형외과학교실) ;
  • 김지섭 (이화여자대학교 의과대학 이대서울병원 정형외과학교실)
  • Received : 2020.06.23
  • Accepted : 2020.09.07
  • Published : 2020.12.30
⟨ Previous Next ⟩

Abstract

Fingers are body parts with a complex structure and essential functions that are the most prone to trauma. The principle of treatment for finger fractures is to determine the balance between obtaining stable fracture fixation and early joint movement. Despite proper treatment, there are many cases of functional and cosmetic problems caused by stiffness or deformation as complications. This review article introduces the latest knowledge in the treatment of finger fractures focusing on fractures and dislocations around the interphalangeal joints, including joint surface damage, which is difficult to treat and leads to poor results. This article consists of fracture cases and describes the methods and solutions to address these complications.

수지는 복잡한 구조와 필수적인 기능을 가진 신체 부위로, 외상에 노출되기 가장 쉬운 부위이다. 수지 골절의 치료 원칙은 적절한 고정으로 골절부의 안정성을 획득하는 것과 안정성을 담보로 한 조기 관절 운동 간의 균형을 신중하게 결정하는 것이다. 치료에도 불구하고 합병증으로 강직이나 변형 등으로 인해 기능적, 미용적 문제가 되는 경우가 많다. 본 종설은 수지 골절 치료의 최신 지견을 소개하고, 치료가 어렵고 결과가 좋지 않은 것으로 알려진 관절면의 손상을 포함한 지절 관절 주위의 골절 및 탈구 위주로 정리하였으며, 치료 증례 소개와 합병증에 대한 접근 및 치료 순서로 기술하였다.

Keywords

References

  1. Lutsky KF, Edelman D, Leinberry C, et al. A prospective evaluation of complications after use of exposed pins in the hand and wrist. Plast Reconstr Surg. 2019;144:659-64. https://doi.org/10.1097/PRS.0000000000005921
  2. Bezuhly M, Sparkes GL, Higgins A, Neumeister MW, Lalonde DH. Immediate thumb extension following extensor indicis proprius-to-extensor pollicis longus tendon transfer using the wide-awake approach. Plast Reconstr Surg. 2007;119:1507-12. https://doi.org/10.1097/01.prs.0000256071.00235.d0
  3. Hyatt BT, Rhee PC. Wide-awake surgical management of hand fractures: technical pearls and advanced rehabilitation. Plast Reconstr Surg. 2019;143:800-10. https://doi.org/10.1097/PRS.0000000000005379
  4. Hong J, Kang HJ, Whang JI, et al. Comparison of the wideawake approach and conventional approach in extensor indicis proprius-to-extensor pollicis longus tendon transfer for chronic extensor pollicis longus rupture. Plast Reconstr Surg. 2020;145:723-33. https://doi.org/10.1097/prs.0000000000006611
  5. Kang HJ, Lee SK. Open accurate reduction for irreducible mallet fractures through a new pulp traction technique with primary tendon repair. J Plast Surg Hand Surg. 2012;46:438-43. https://doi.org/10.3109/2000656X.2012.727822
  6. King HJ, Shin SJ, Kang ES. Complications of operative treatment for mallet fractures of the distal phalanx. J Hand Surg Br. 2001;26:28-31. https://doi.org/10.1054/jhsb.2000.0440
  7. Leddy JP, Packer JW. Avulsion of the profundus tendon insertion in athletes. J Hand Surg Am. 1977;2:66-9. https://doi.org/10.1016/S0363-5023(77)80012-9
  8. Smith JH Jr. Avulsion of a profundus tendon with simultaneous intraarticular fracture of the distal phalanx: case report. J Hand Surg Am. 1981;6:600-1. https://doi.org/10.1016/S0363-5023(81)80141-4
  9. Al-Qattan MM. Type 5 avulsion of the insertion of the flexor digitorum profundus tendon. J Hand Surg Br. 2001;26:427-31. https://doi.org/10.1054/jhsb.2001.0619
  10. Kang N, Pratt A, Burr N. Miniplate fixation for avulsion injuries of the flexor digitorum profundus insertion. J Hand Surg Br. 2003;28:363-8. https://doi.org/10.1016/S0266-7681(03)00100-1
  11. Shewring DJ, Miller AC, Ghandour A. Condylar fractures of the proximal and middle phalanges. J Hand Surg Eur Vol. 2015;40:51-8. https://doi.org/10.1177/1753193413508514
  12. McElfresh EC, Dobyns JH, O'Brien ET. Management of fracture-dislocation of the proximal interphalangeal joints by extension-block splinting. J Bone Joint Surg Am. 1972;54:1705-11. https://doi.org/10.2106/00004623-197254080-00010
  13. Viegas SF. Extension block pinning for proximal interphalangeal joint fracture dislocations: preliminary report of a new technique. J Hand Surg Am. 1992;17:896-901. https://doi.org/10.1016/0363-5023(92)90464-Z
  14. Hynes MC, Giddins GE. Dynamic external fixation for pilon fractures of the interphalangeal joints. J Hand Surg Br. 2001;26:122-4. https://doi.org/10.1054/jhsb.2000.0521
  15. Calfee RP, Kiefhaber TR, Sommerkamp TG, Stern PJ. Hemi-hamate arthroplasty provides functional reconstruction of acute and chronic proximal interphalangeal fracture-dislocations. J Hand Surg Am. 2009;34:1232-41. https://doi.org/10.1016/j.jhsa.2009.04.027
  16. Kuhn KM, Dao KD, Shin AY. Volar A1 pulley approach for fixation of avulsion fractures of the base of the proximal phalanx. J Hand Surg Am. 2001;26:762-71. https://doi.org/10.1053/jhsu.2001.24149
  17. Yamanaka K, Yoshida K, Inoue H, Inoue A, Miyagi T. Locking of the metacarpophalangeal joint of the thumb. J Bone Joint Surg Am. 1985;67:782-7. https://doi.org/10.2106/00004623-198567050-00014
  18. Buchler U, McCollam SM, Oppikofer C. Comminuted fractures of the basilar joint of the thumb: combined treatment by external fixation, limited internal fixation, and bone grafting. J Hand Surg Am. 1991;16:556-60. https://doi.org/10.1016/0363-5023(91)90032-7
  19. Harness NG, Chen A, Jupiter JB. Extra-articular osteotomy for malunited unicondylar fractures of the proximal phalanx. J Hand Surg Am. 2005;30:566-72. https://doi.org/10.1016/j.jhsa.2004.12.003
  20. Teoh LC, Yong FC, Chong KC. Condylar advancement osteotomy for correcting condylar malunion of the finger. J Hand Surg Br. 2002;27:31-5. https://doi.org/10.1054/JHSB.2001.0694
  21. Jupiter JB, Koniuch MP, Smith RJ. The management of delayed union and nonunion of the metacarpals and phalanges. J Hand Surg Am. 1985;10:457-66. https://doi.org/10.1016/S0363-5023(85)80066-6
  22. Wei DH, Terrono AL. Superficialis sling (flexor digitorum superficialis tenodesis) for swan neck reconstruction. J Hand Surg Am. 2015;40:2068-74. https://doi.org/10.1016/j.jhsa.2015.07.018
  23. Swanson A. Surgery of the hand in cerebral palsy and the swan-neck deformity. J Bone Joint Surg Am. 1960;42:951-64. https://doi.org/10.2106/00004623-196042060-00004
  24. Curtis RM, Reid RL, Provost JM. A staged technique for the repair of the traumatic boutonniere deformity. J Hand Surg Am. 1983;8:167-71. https://doi.org/10.1016/S0363-5023(83)80009-4
  25. Stern PJ. Extensor tenotomy: a technique for correction of posttraumatic distal interphalangeal joint hyperextension deformity. J Hand Surg Am. 1989;14:546-9. https://doi.org/10.1016/S0363-5023(89)80022-X