Surgical Treatment of Periarticular Malunion Blocking Interphalangeal Joint

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Journal of the Korean Society for Surgery of the Hand 2006;11(2):111-115.
Published online June 1, 2006.

Kyung Hwan Moon, Jin Soo Kim, Dong Chul Lee, Sae Hwi Ki, Si Young

지관절 굴곡을 방해하는 수지 부정유합의 수술적 치료

문경환, 김진수, 이동철, 기세휘, 노시영, 양재원

Abstract

When malunion or nonunion of periarticular fracture of finger occurs,‘ Bony Blocking Spur’which can block flexion may result. Removal of the blocking spur gives more range of motion (ROM) to the joint. From June 2003 to February 2005, a total of 11‘ Bony Blocking Spur’resection was performed in 11 patients. Diagnosis may be misjudged if true lateral radiography is not obtained so that finger lateral flexion/extension view can be helpful. After mid-lateral incision exposing articular surface, passive flexion of the joint demonstrates the area of bony block and a small rongeur is used to remove this prominence. This has to be done repeatedly until the desired degree of flexion is attained. Activeassisted range of motion exercise is started when the patient is comfortable and inflammation sign is subside. Range of motion was improved in 10 cases, but in 1 case, only passive flexion was improved because of low compliance of postoperative exercise. ‘Blocking bony spur’can limit range of motion of joint. Proper diagnosis with true lateral X-ray in flexion and extension of joint and resection of bony spur is good option for malunion of periarticular fracture.

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