拇指指间(IP)关节脱位由于关节的固有稳定性而罕见。本报告介绍了一例复杂的不可还原背侧IP关节脱位的拇指,由于四个结构的插入-掌板,芝麻骨,屈屈肌腱和指神经,这可能是迄今为止文献中报道的唯一病例,其中涉及该关节不可还原的三个以上结构。作者对以前在文献中报道的类似病例报告进行了比较回顾,列出了管理中的争议,并在这些困难伤害的管理中形成了广泛的共识。最后,本文提出了一种管理这些损伤的算法,该算法可能有助于其他操作员解决这些损伤,从而提供可预测的治疗结果。
Dislocations of thumb interphalangeal (IP) joint are rare injuries due to inherent stability of the joint. This report presents a case of complex irreducible dorsal IP joint dislocation of thumb due to interposition of four structures - volar plate, sesamoid bone, flexor pollicis longus tendon and digital nerve which is perhaps the only case reported so far in literature where more than three structures have been implicated for this joint irreducibility. The author presents a comparative review of similar case reports previously reported in literature listing the controversies in management and forming a broad
consensus in the management of these difficult injuries. Finally, an algorithm for the management of these injures has been proposed in this article which maybe helpful for other operators in tackling these injuries so as to deliver predictable treatment outcomes.