改良式伸肌腱止点重建治疗锤状指畸形

摘要

To explore a modified fixation method of reconstruction of extensor tendon insertion point. Method:20 cases of mallet finger patients were treated from December 2012 to December 2013 in our hospital,the distal interphalangeal joint hyperextension position 10-15 degree by 1 mm diameter Kirschner wire fixation in operation.The distal remoted about 2 cm and to palmar bent into a hook,with a fine wire acrossed the extensor tendon of finger pulpped extract Kirschner wire fixation in bending.Result:20 cases with modified method by extensor tendon reconstruction, postoperative no localized tissue necrosis and tendon ruptures,patients were followed up for 3-6 months,according to Dargan function evaluation:excellent in 17 cases,good in 2 cases,acceptable outcome in 1 cases,poor in 0 cases,the excellent and good rate was 95%.Conclusion:The modified extensor tendon reconstruction technique can effectively avoid the local tissue necrosis,reconstruction and reliable effect,it is worth the clinical promotion.%目的：探讨一种指伸肌腱止点重建的改良固定方法。方法：对2012年12月-2013年12月在本院治疗的20例锤状指患者，术中采用直径1.0 mm克氏针将远指间关节固定于过伸位10°~15°，远端预留约2 cm并向掌侧弯曲成一钩状，用细钢丝横穿伸肌腱止点经指腹抽出固定于折弯的克氏针上，6周后拔除克氏针及钢丝进行远指间关节屈伸功能锻炼。结果：20例用改良后的方法行伸肌腱止点重建，术后没有发生局部组织坏死和肌腱再断裂，术后随访3~6个月，按Dargan功能评定法：优17例，良2例，尚可1例，差0例，优良率95%。结论：改良后的指伸肌腱止点重建技术有效避免了局部组织坏死，重建效果可靠，值得临床推广。