Correction of proximal interphalangeal joint hyperextension

Proximal interphalangeal joint overextension surgery for surgical treatment of rheumatoid arthritis of the hand joint. Treatment of diseases: osteoarthritis Indication The proximal interphalangeal joint overextension correction is suitable for the gooseneck deformity that can be corrected by hand, and the X-ray film has no obvious change. Surgical procedure 1, cutting and revealing Make a Z-shaped skin incision on the palm of the proximal and middle sections of the finger. At the overextended proximal interphalangeal joint, the finger nerves are attached to the intersection of the trochlear, and care should be taken to avoid damage. Free the finger nerve vascular bundles on both sides, fully revealing the intersection of the pulley and the A2 ring block. The middle part of the pulley was cut in the middle to reveal the flexor tendon. 2, excision of synovial lysis Retract the flexor digitorum tendon, loosen the adhesion to the surrounding tissue, reveal the flexor digitorum tendon, loosen the adhesion, and remove the synovium. The flexor digitorum tendon is pulled to the distal end, and the bifurcation is cut and split into two bundles. If the adhesion is extensive, the incision can be extended proximally and the adhesion can be loosened at the level of the A1 pulley to facilitate pulling the tendon distally. 3, fixed The split flexor digitorum tendon is pulled distally and the ulnar side bundle is severed to retain a bundle of about 5 cm in length on the mid phalanx. Pull the ulnar side stump and check if it is firmly attached to the phalanx. When the little finger is too thin due to the flexion of the flexor digitorum, both bundles can be cut. On the A2 block, cut a small hole from the distal edge of 3 to 4 mm, insert a small hemostatic forceps into the flexor tendon sheath through the small hole, and clamp the proximal end of the lateral flexion of the flexor digitorum muscle. Pulled to the near side and pulled out through the A2 pulley. The broken end was turned to the distal side and sutured with its distal portion with a 4-0 non-absorbent line. Adjust the tension of the tendon so that the proximal interphalangeal joint can maintain a 5° flexion position. 4, close the incision Repair the intersection of the pulley if possible. Stitch the skin.