proximal phalanx head neck resection

Hammer toe refers to the flexion deformity of the proximal interphalangeal joint of the toes. Such malformations can be plasticity, passive can be corrected, can also be fixed, passive can not be corrected. If the deformity is severe, after a long period of time, the metatarsophalangeal joint of the same toe may have an overextension, and the distal interphalangeal joint may also have a flexion or an overextension. Severe fixed hammer toe, due to the compression of the shoe during weight bearing, the hard corns that can cause pain on the dorsal side of the proximal interphalangeal joint, the painful end of the cornea on the temporal side of the toe nail, in the toe humerus Painful convulsions can form under the head. Because of deformities and pain, it can affect wearing shoes and walking. For malleable hammer toes of adolescents or young adults, soft tissue surgery can be used for correction. Taylor and Prris describe the use of extensor tendons displaced to the dorsal aspect of the proximal phalanx to correct the malleable hammer toe. Lapidus introduced the flexor tendon severing of the proximal and distal interphalangeal joints, the incision of the temporal joint capsule, and the suture of the dorsal joint capsule. At the same time, the joint capsule was opened and the extensor tendon was cut off on the dorsal aspect of the metatarsophalangeal joint. The sutured joint capsule is overlapped and sutured to correct the malleable hammer toe. For adult fixed hammer toes, bone and joint surgery is generally required to correct the deformity. Commonly used operations include proximal interphalangeal arthroplasty or arthrodesis, proximal phalangeal proximal hemisection or distal hemisection, proximal phalangeal proximal and distal resection, etc., depending on the deformity of the case application. Treating diseases: corns Indication The proximal phalangeal head and neck resection is suitable for fixed hammer toe deformity, and hard corns with pain on the dorsal side of the proximal interphalangeal joint, affecting adult patients wearing shoes and walking. Preoperative preparation Including skin preparation, osteotome, wire saw, osteophytes and other orthopedic instruments. Surgical procedure 1. Make a transverse diamond incision on the dorsal side of the proximal interphalangeal joint, 5~6mm wide, and then extend to 2~3mm on both sides. Excision of the skin on the dorsal side of the proximal interphalangeal joint, corns, a small extensor tendon and Joint capsule. When cutting the central bundle of the extensor tendon, the base of the phalanx should be left 2 to 3 mm to facilitate suturing. 2. Cut the collateral ligaments on both sides of the proximal interphalangeal joint and then flex them to a 90° position to reveal the head and neck of the proximal phalanx. Use a bone knife or wire saw to remove the head and neck of the proximal phalanx so that the toes can be passively straightened. If you still can't straighten, you can remove some of the bone on the far side of the proximal phalangeal bone until it can be passively straightened. The broken ends of the bones are smoothed with bone honing. 3, suture joint capsule, toe extensor tendon and skin. complication The main complication is uncorrected or recurrent deformity, which should be prevented during surgery and postoperative.

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