■病理性指骨骨折是指孤立性内软骨瘤的常见初始表现。中指骨的软骨瘤最常与术后运动范围缺陷相关。本报告描述了一个案例,其中在手术固定中指中内软骨瘤伴伸肌腱损伤的病理性骨折后,使用克氏针(K线)和同种异体骨修复手指运动。
■一名37岁的右手优势女子表现为左食指中指骨病理性骨折。患者选择进行手术干预,以稳定骨折并使近端指间关节(PIP)早期运动。手术固定术涉及肿瘤刮除术,用纵向K线进行断裂稳定和长度保持,具有硬化特性的同种异体骨填充骨缺损,和用于固定伸肌腱的背侧K线。术后11个月随访,同种异体移植几乎完全解决了,患者恢复了PIP90°屈曲和完全伸展。
■中指骨内生软骨瘤的病理性骨折容易因伸肌腱损伤和相关的术后运动丧失而发生并发症。植骨和克氏针固定可以早期动员手指运动,因此可能是治疗其他病理性骨折的有用技术。
UNASSIGNED: Pathologic phalangeal fracture is a common initial presentation of solitary
enchondroma of the finger. Enchondromas of the middle phalanx are most frequently associated with post-operative range of motion deficits. This report describes a case in which the use of Kirschner wires (K-wires) and allograft bone were used to salvage finger motion following surgical fixation of pathologic fracture of a middle phalanx
enchondroma with extensor tendon injury.
UNASSIGNED: A 37-year-old right hand dominant woman presents with pathologic fracture of the left index finger middle phalanx. The patient elected for surgical intervention to stabilize fracture and enable early motion at the proximal interphalangeal joint (PIP). Surgical fixation involved tumor curettage, fracture stabilization and length preservation with longitudinal K-wires, allograft bone with hardening properties to fill the bony defect, and dorsal K-wires for securing the extensor tendon. At follow-up 11 months postoperatively, the allograft had almost completely resolved, and the patient had regained PIP flexion of 90° and full extension.
UNASSIGNED: Pathologic fracture of middle phalanx
enchondroma is prone to complication by extensor tendon injury and associated post-operative loss of motion. Bone grafting and Kirschner wire fixation allowed for early mobilization of finger motion and thus may be a useful technique for use in treatment of other pathologic fractures.