Open reduction of middle phalanx fractures

Applicable to the middle phalanx fractures. Treatment of diseases: phalangeal fractures Indication Applicable to the middle phalanx fractures. Preoperative preparation 1. The fracture is caused by severe trauma. The patient has severe pain and blood loss. Analgesic and blood matching should be given before surgery. For patients with poor general condition or existing shock, anti-shock treatment such as infusion and blood transfusion should be given, and the operation should be performed after the condition is stable. 2. Preoperative fracture sites should be taken with positive lateral radiographs to determine the location, shape and displacement of the fracture, which is convenient for determining the surgical procedure and internal fixation. For those who need to take X-rays during surgery, they should inform the radiology department and the operating room in advance to prepare. 3. The surgeon should propose the special equipment to be used and check whether the preparation of the equipment is complete, so as to avoid temporary preparation and prolong the operation time. 4. Open fractures should be treated with antibiotics and tetanus antitoxins; or if the original open fractures were delayed for more than 2 weeks, antibiotics and repeated injections of tetanus antitoxin should be used. 5. After the reduction and reduction, the internal fixation or bone graft should be used. The antibiotic should be intravenously administered immediately after anesthesia, and once every 6 hours, share 4 times. 6. The fracture site should have sufficient range of cleaning and disinfection preparations. The surgeon should avoid contact with the suppurative wound on the same day, and strictly follow the hand washing procedure to prevent the wound infection. 7. Patients who need to delay surgery for the first time should be towed first, can be reset, temporarily fixed, and can overcome soft tissue contracture, reducing the difficulty of resetting during surgery. 8. Need to simultaneously bone fractures, such as delayed bone fractures, slow healing fractures, etc., should be prepared for the bone area after surgery. Surgical procedure 1. Middle right middle finger fracture. The fracture is located distal to the distal point of the superficial flexor tendon, and the distal fracture segment is overextended to the dorsal side. Treatment with open reduction and internal fixation can make a good reset. Simplify external fixation to facilitate early joint activity. 2. The back side of the middle finger of the injured finger is made into an arc-shaped incision to expose the extensor tendon. 3. Retract the two lateral tendons of the extensor tendon to both sides to reveal the fracture end. Clean the clots at the fracture end and do not perform fracture reduction for the time being. 4. Make a cross retrograde needle at the distal end of the fracture. The distal ends of the needles are respectively pierced from the opposite sides of the distal end of the middle finger. 5. Reset the fracture under direct vision. Two Kirschner wires were inserted from the distal side into the proximal fracture segment to complete the internal fixation. 6. Stitch 2~3 needles at the intersection of the two sides of the extensor tendon to restore the tendon to its original position. 7. The X-ray positive lateral slice confirmed that the fracture was well restored and the internal fixation position was accurate. 8. Close the wound and use a plaster or plastic plate to brake the finger in the functional position. After 4 weeks, the injured finger can begin to have protective joint activity. complication Can be complicated by median nerve injury and flexor tendon rupture.