근위지간 관절의 중위지골 기저부 수장판 견열 골절의 수술적 치료

Abstract

Unreduced volar plate avulsion fracture of base of middle phalanx in proximal interphalangeal(PIP) joint result in chronic joint instability, traumatic arthritis, joint stiffness, deformity. In spite of various operative method recommended, this injury remains a problematic obstacles in the management. Sixteen patients who received operative treatment for this injury from 1992 to 1999 at Yongdong Severance Hospital were analized retrospectively. The indication of surgical treatment included articular fracture involved over 30% articular surface, displacement over 2~3 mm, impingement by interposition of fragment into joint cavity and open fracture. The patients were all man and the mean age was 28.8 years old(16~57). The third finger of dominant hand was the most commonly involved site. Eight cases received an open reduction and internal fixation and seven cases, closed reduction and external fixation. The remaining one case received a volar plate arthroplasty. At one year postoperation, clinical result, evaluated by Steel’s scor-ing method, showed excellent, good in thirteen cases (81%). There were two complicated cases; one case of traumatic arthritis and the other case of severe PIP joint contracture where the active range of motion was less than 10°. This results suggest the good result can be obtained by operative treatment for which well operatively indicated patients and proper operative method are selected.