Open reduction of dorsal fracture of distal phalanx base

Applicable to the dorsal fracture of the basal basal bone. Treatment of diseases: hand trauma fractures Indication Applicable to the dorsal fracture of the basal basal bone. Contraindications There are more than 8 to 12 hours of open wounds in the fracture. 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. The distal part of the basal humeral avulsion fracture, the proximal fracture block is pulled by the extensor tendon and turned to the dorsal side. The distal phalanx is slightly dislocated to the volar side. 2. Make a Z shaped incision on the dorsal side of the distal interphalangeal joint to reveal the fracture. Be careful not to damage the nail and nail bed. 3, the proximal fracture block with a Kirschner wire retrograde penetration, self-referencing back. 4, the surgeon with the finger to hold the injury to the end of the reduction, the other hand to control the Kirschner wire, the fracture is reset. 5. The Kirschner wire is inserted into the distal fracture block from the proximal fracture block to complete the internal fixation. 6, orthotopic X-ray film showed good fracture reduction. 7, lateral X-ray film showed good fracture reduction. complication Can be complicated by median nerve injury and flexor tendon rupture.

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