Anterior fracture dislocation of the PIP joint - A case report.

概要

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Anterior fracture dislocation of the PIP joint is far less common injury than the dorsal fracture dislocation. Since this injury contains the fracture of the dorsal lip of the middle phalanx, open reduction and K-wire fixation are recommended to avoid a boutoniére deformity. However it is difficult to treat when the fragment is small or comminuted.We treated this injury by reversed Rovertson's traction. The patient was a 21-year-old man. He sustained an anterior fracture dislocation of the PIP joint of his right little finger when he playing was baseball. The ball hit the dorsal aspect of his middle phalanx. X-ray photogragh showed an anterior displacement of the middle phalanx with a comminution of the dorsal lip.A traction was applied at the proximal phalanx to volarward, at the middle phalanx to dorsalward and at the distal phalanx to distalward.The traction was continued about four weeks followed by immobilization with the metal splint for more two weeks.The patient gained almost full ROM with minimum extension loss. We appreciated that a reversed Rovertson's traction was a useful technique in the treatment for the injury like this case.
西日本整形・災害外科学会の論文