제5 수지 근위지골 기저부 골절의 수술적 치료

Abstract

Fractures in metacarpophalangeal joint are mainly divided into metacarpal neck fracture and proximal phalangeal base fracture. The proximal phalangeal base fracture occurs easily in little finger because it is a peripheral finger with no outside protection. Fractures of proximal phalangeal base of little finger cause angular deformity and limitation of motion of little finger frequently. We have studied thirteen patients with the proximal phalangeal base fractures of the little finger. The average age was 25.7 years (range 8-63 years) and most of patients were included in 2nd and 3rd decades. Closed reduction and percutaneous pinning was performed in 9 cases and open reduction and internal fixation with Kirschner's wires in 4 cases. Dorsal angulation was present in all cases (average 25¡Æ) and ulnar angulation in 10 cases (average 10¡Æ) preoperatively. Angular deformities were corrected to average dorsal angulation 8.5¡Æand average ulnar angulation 0¡Æ. Dorsal angulation was not corrected enough in two cases and resulted in limitation in full grip and range of motion. Ulnar rotation deformity of 30¡Æwith limitation of motion of the little finger developed during the follow-up period in one case.

Weakness and instability in grip were noted in three cases. In conclusion, the proximal phalangeal base fracture of the little finger causes angulation and rotation deformity frequently. As a result, the limitation of full grip and range of motion of the little finger developed. And so, the operative treatment should be considered for the anatomical reduction and firm fixation of the proximal phalangeal base fracture of the little finger if closed reduction fail.