人工关节置换治疗创伤性手指近侧指间关节缺损

Treatment of traumatic proximal interphalangeal joint defect with artificial joint replacement

目的探讨人工关节假体置换治疗创伤性近侧指间关节缺损畸形的可行性，评价其术后疗效。方法白2007年9月至2010年11月，对l0例创伤性近侧指间关节缺损畸形病例二期行人工关节置换术，示指5例，中指4例，环指1例，其中再造手指1例。结果10例患者手术顺利，伤口一期愈合，术中、术后未发生任何并发症。所有患者均获8个月到3年的随访，置换的近侧假体关节外观和运动功能良好，伸屈活动范围50°-80°。根据中华医学会手外科学会上肢部分功能评定试用标准评定，本组l0例手功能评定：优6例，良3例，可1例。结论人工关节假体置换治疗创伤性手指近侧指间关节缺损畸形具有手术操作简便、创伤小、恢复快的优点，是一种较为有效的新方法。

To investigate the treatment efficacy of traumatic proximal interphalangeal （PIP） joint defects with prosthetic replacement. Methods From September 2007 to November 2010, ten patients with joint defect injuries were treated by joint prosthetic replacement （5 index fingers, 4 middle fingers, and 1 ring finger）, including a reconstructed middle finger. Joint motion range and postoperative pain of all cases were measured to evaluate the treatment. Results All cases went through a smooth operation with primary wound healing, and with neither intraoperative nor postoperative complications happened. The followup period was range from 8 months to 2 years. The active motion arcs of PIP joints ranged from 50° to 80°, and satisfacto- ry appearances as well. According to assessment standard of upper extremity described by Chinese Hand Surgery Association, the treatment outcome were excellent in 6 fingers, good in 3 fingers, general in 1 finger. Conclusion Joint prosthetic replacement is a new effective method to treat traumatic proximal interphalangeal joint defect, which is a simple operation with advantages of little trauma and rapid recovery.