单纯克氏针与微型骨锚钉联合克氏针治疗DoyleⅠa型锤状指的疗效对比

摘要

Objective To compare the clinical efficacy between simple Kirschner wire and mini bone anchor combined with Kirschner wire fixation in the treatment of Doyle type Ⅰ a mallet fingers. Methods A retrospective analysis was conducted in 33 patients with Doyle type Ⅰ a mallet fingers treated in our department from November 2013 to November 2016. Among them 16 patients were treated with Kirschner wire fixation (group A), while 17 patients were treated with mini bone anchor combined with Kirschner wire fixation (group B). Statistical analysis was made on the range of active motion of the distal interphalangeal joint, pain and complications between two groups. Results The patients in group A were follow-up for 10 to 21 months with an average of 13.6 months, while the patients in group B were follow-up for 10 to 18 months with an average of 13 months. There were no significant differences in the range of active motion of the distal interphalangeal joint and pain between the two groups (P>0.05). According to Crawford's criteria for evaluating the clinical efficacy of mallet finger, results of group A were excellent in 3 cases, good in 10 cases and fair in 3 cases; group B were excellent in 2 cases, good in 12 cases, fair in 2 cases and poor in 1 case. There were 3 cases of nail deformity in group A and 1 case of infection, 2 cases of suture knot exposure and 4 cases of nail deformity in group B. Conclusion Simple Kirschner wire and mini bone anchor combined with Kirschner wire fixation in the treatment of Doyle type Ⅰ a mallet fingers have similar clinical efficacy. However the incidence of complications is lower in simple Kirschner wire group.%目的 对比单纯克氏针与微型骨锚钉联合克氏针治疗DoyleⅠa型锤状指的疗效.方法 回顾性分析2013年11月至2016年11月于我科就诊并接受手术的33例DoyleⅠa型锤状指患者,其中16例患者行单纯克氏针治疗(A组),17例患者行微型骨锚钉联合克氏针治疗(B组).对两组远指间关节的主动屈曲角度、欠伸角度、疼痛及并发症等情况进行统计学分析.结果 术后A组随访时间为10～21个月,平均13.6个月;B组随访时间为10～18个月,平均13.1个月.两组间远指间关节主动屈曲角度、欠伸角度、疼痛度差异无统计学意义(P>0.05).参照Crawford锤状指疗效评估标准进行评定:A组优3例,良10例,可3例;B组优2例,良12例,可2例,差1例.A组出现3例指甲畸形,B组出现1例感染、2例线结外露和4例指甲畸形.结论 单纯克氏针与微型骨锚钉联合克氏针治疗DoyleⅠa型锤状指相比,疗效接近,术后并发症发生相对较少.