枪伤后掌指关节抢救：一个病例系列和文献回顾

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-01-01 DOI:10.1016/j.jhsg.2024.11.004

Reece A. Moore MD , Jacob Franke MD , Matthew Fahrenkopf MD

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引用次数: 0

摘要

对于破坏性枪伤（GSW）损伤的患者，可以考虑采用掌指关节置换术。我们报告了两例手部低速GSW患者，涉及MCP关节，需要使用关节置换术挽救MCP关节。每个患者使用不同的关节成形术，包括炭半关节成形术和硅胶关节成形术。对于热炭半关节置换术，术后9个月MCP、近端指间关节和远端指间关节的总活动弧度分别为70º、110º和80º。对于硅胶关节置换术，术后9个月MCP、近端指间关节和远端指间关节的总活动弧度分别为85º、120º和80º。术后9个月随访时，两例患者均恢复正常工作，无慢性疼痛。在这一人群中，应用热炭或硅胶关节成形术治疗GSWs是一种可行的关节修复选择。

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Metacarpophalangeal Joint Salvage Following Gunshot Wounds: A Case Series And Literature Review

Metacarpophalangeal (MCP) joint arthroplasty may be considered for patients with destructive gunshot wound (GSW) injuries. We present a review of two patients who sustained a low-velocity GSW of the hand with involvement of an MCP joint requiring MCP joint salvage using arthroplasty. Differing arthroplasty methods were used for each patient including pyrocarbon hemiarthroplasty and silicone arthroplasty. For pyrocarbon hemiarthroplasty, total arc of motion at 9 months after surgery for the MCP, proximal interphalangeal, and distal interphalangeal joints were 70º, 110º, and 80º, respectively. For silicone arthroplasty, total arc of motion at 9 months after surgery for the MCP, proximal interphalangeal, and distal interphalangeal joints were 85º, 120º, and 80º, respectively. Both patients returned to work without restrictions and were without chronic pain at the last follow-up 9 months from salvage surgery. The application of pyrocarbon or silicone arthroplasty for GSWs is a viable option for joint salvage in this population.

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