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首页> 外文期刊>Journal of hand therapy: Official journal of the American Society of Hand Therapists >Management of a proximal interphalangeal joint fracture dislocation with a compass proximal interphalangeal joint hinge and therapy: a case report.
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Management of a proximal interphalangeal joint fracture dislocation with a compass proximal interphalangeal joint hinge and therapy: a case report.

机译：用指南针治疗近端指间关节骨折脱位并治疗：一例病例报告。

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摘要

The purpose of this report is to describe the management of a chronic proximal interphalangeal (PIP) joint fracture dislocation in a 46-year-old computer programmer. Twenty days following injury, a right ring finger volar plate arthroplasty was performed, loose fracture fragments were excised, and a Compass PIP joint hinge was applied. The hinge was locked at 10 degrees to 15 degrees extension and held in this position for 8 days. On postoperative day 8, hand therapy was initiated. Many challenges were encountered. Insurance constraints required the patient to change therapists. The device frame cracked. The patient developed a PIP joint contracture with extensor lag. Despite these obstacles, the patient achieved a successful outcome, returning to normal pain-free use with grip strength at 87% of that of the uninvolved hand. At discharge, active range of motion was 12 degrees/100 degrees at the PIP joint and 0 degrees/40 degrees at the DIP joint. Passive extension was 0 degrees. At 6 months postoperatively, active range of motion was 0 degrees/105 degrees at the PIP joint and 0 degrees/60 degrees at the DIP joint. This case demonstrates the need for closely supervised postoperative therapy that includes good communication between providers, ongoing patient education, and close monitoring of range of motion.
机译：本报告的目的是描述一名46岁的计算机程序员对慢性近端指间（PIP）关节骨折脱位的处理。受伤后二十天，进行右无名指掌骨小板置换术，切除松动的骨折片段，并应用Compass PIP关节铰链。将铰链锁定在10度到15度的延伸范围内，并在此位置保持8天。术后第8天，开始手部治疗。遇到了许多挑战。保险限制要求患者更换治疗师。设备框架破裂。该患者出现PIP关节挛缩伴伸肌迟滞。尽管有这些障碍，患者还是取得了成功的结果，恢复了正常的无痛使用，握力为未受累手的87％。放电时，活动的活动范围在PIP关节处为12度/ 100度，在DIP关节处为0度/ 40度。被动延伸为0度。术后6个月，活动范围在PIP关节为0度/ 105度，在DIP关节为0度/ 60度。该病例表明需要密切监督的术后治疗，包括提供者之间的良好沟通，持续的患者教育以及对运动范围的密切监视。

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