骨科英文书籍精读（156）｜指间关节脱位

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INTERPHALANGEAL JOINT DISLOCATION

Distal joint dislocation is rare; proximal joint dislocation is more common. The dislocation is easily reduced by pulling. The joint is strapped to its neighbour for a few days and movements are begun immediately. The lateral x-ray may show a small flake of bone, representing a palmar plate avulsion; this should be ignored. The patient must be warned that it can take many months (and sometimes forever) for the spindle-like swelling of the joint to settle and for full extension to recover. If there is a large palmar fragment with displacement, then this should be reduced and fixed. If closed reduction is successful, then an extension splint or temporary transarticular wire is used. If it cannot be reduced or remains unstable then screw fixation or a small wire loop can be used. If there is marked comminution and instability, the joint is exposed from the palmar surface, the damaged fragments are excised and the palmar plate is reattached to the base of the proximal phalanx (‘palmar-plate arthroplasty’).

---from 《Apley’s System of Orthopaedics and Fractures》

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重点词汇整理：

flake/fleɪk/n. 小薄片，碎片；古怪的人

a small flake of bone一小片骨头

spindle /ˈspɪndl/n. 轴；纺锤，锭子；细长的人或物

loop/luːp/v. 使成环；环行；放磁带，执行计算机指令；（使飞机）翻筋斗n. 环状物、圈

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百度翻译：

指间关节脱位

远端关节脱位少见，近端关节脱位较常见。拉拔容易使位错减少。关节被绑在附近几天，立即开始活动。侧位x光片可显示一小片骨片，代表掌骨板撕脱；这一点应忽略不计。必须提醒患者，关节的纺锤状肿胀可能需要数月（有时甚至永远）才能消退，完全伸展才能恢复。如果掌骨有较大的移位碎片，应复位固定。如果闭合复位成功，则使用延长夹板或临时跨关节钢丝。如果不能缩小或保持不稳定，则可使用螺钉固定或小钢丝环。如果有明显的粉碎和不稳定，关节从掌骨表面暴露出来，切除老化的碎片，掌板重新附着在近节指骨的基底上（“掌板关节成形术”）。

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