| 微型骨锚联合掌长肌腱片移植治疗陈旧性锤状指畸形 |
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投稿时间：2015-05-21
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| 作者 | Author | 单位 | Address | E-Mail |
| 彭辉煌 |
PENG Hui-huang |
温州医科大学附属第三医院手外科, 浙江 瑞安 325200 |
Department of Hand Surgery, the 3rd Hospital of Wenzhou Medical University, Ruian 325200, Zhejiang, China |
peng6t7y@126.com |
| 吴建伟 |
WU Jian-wei |
温州医科大学附属第三医院手外科, 浙江 瑞安 325200 |
Department of Hand Surgery, the 3rd Hospital of Wenzhou Medical University, Ruian 325200, Zhejiang, China |
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| 杨国敬 |
YANG Guo-jing |
温州医科大学附属第三医院手外科, 浙江 瑞安 325200 |
Department of Hand Surgery, the 3rd Hospital of Wenzhou Medical University, Ruian 325200, Zhejiang, China |
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| 期刊信息：《中国骨伤》2015年，第28卷，第11期，第1017-1020页 |
| DOI：10.3969/j.issn.1003-0034.2015.11.009 |
| 基金项目: |
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中文摘要:
目的:探讨采用微型骨锚和掌长肌腱片移植治疗陈旧性锤状指的临床疗效。
方法:自2008年1月至2013年6月,采用微型骨锚和掌长肌腱片移植治疗26例陈旧性锤状指患者,其中男18例,女8例;年龄18～52岁,平均(32.0±1.3)岁;机器绞伤8例,摔伤6例,打架扭伤6例,自发性断裂4例,刀伤2例。16例患者伸肌腱止点无肌腱附丽,10例有0.3～0.5 cm残留肌腱附丽。患者均有手指末节屈曲畸形,背伸活动障碍。术中将远侧指间关节予以克氏针固定于伸直10°～20°位,运用微型骨锚重建伸肌腱止点,取掌长肌腱片移植伸肌腱止点缺损区,4周后拆除克氏针,辅以石膏外固定下行功能锻炼。观察术后并发症情况,并采用Dargan功能评定标准对手指功能进行评价。
结果:术后所有患者获随访,时间6～14个月,平均(5.0±0.3)个月。术后发生创口浅表感染2例,皮肤压迫性溃疡2例,关节活动障碍1例,均予以对症治疗后好转;发生创伤性关节炎2例,1例治疗后好转,另1例存在长期慢性疼痛;无内固定松动、断裂和肌腱断裂发生。按照Dargan功能评定标准评价手指功能,优17例,良8例,差1例。
结论:采用微型骨锚结合掌长肌腱片治疗陈旧性锤状指畸形,具有手术操作简单,固定牢靠,并发症少,临床疗效肯定等优点,值得临床推广。 |
| 【关键词】肌腱损伤 植入物 锤状指畸形 肌腱移植 |
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| Treatment of chronic mallet finger deformity with minor bone anchors and palmaris longus tendon graft |
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ABSTRACT
Objective:To explore the clinical effects of minor bone anchors and palmaris longus tendon graft in treating chronic mallet fingers deformity.
Methods:From January 2008 to June 2013,26 patients with chronic mallet fingers deformity were treated with minor bone anchors and palmaris longus tendon graft. There were 18 males and 8 females,aged from 18 to 52 years old with an average of (32.0±1.3) years. Among them,8 cases caused by machine injury,6 cases by fall injury,6 cases by sprain from fight,4 cases by tendon spontaneous rupture,2 cases by knife trauma. There was no tendon attachment of extensor tendon check in 16 cases, and with 0.3 to 0.5 cm tendon attachment in 10 cases. All patients had the flexion deformity and the disability of dorsiflexion activity. During operation,the distal interphalangeal joint was fixed in 10 ° to 20° dorsiflexion by a Kirshner wire,the minor bone anchor was used to reconstruct the extensor tendon insertion,the palmaris longus tendon slice was transplanted the decayed area of extensor tendon insertion. Four weeks postoperatively,the Kirshner wire was removed and the plaster external fixation was used,and the patient began function exercises. Postoperative complications were observed and fingers functions were assessed according to Dargan standard.
Results:The patients were followed up from 6 to 14 months with an average of (5.0±0.3) months. Wound superficial infection occurred in 2 cases,the skin pressure ulcer in 2 cases,joint activities disability in 1 case;these symptoms got improvement after symptomatic treatment. Traumatic arthritis occurred in 2 cases,1 case was improved after treatment,and 1 case had chronic pain for a long time. No internal fixation loosening or breakage and tendon rupture were found. According to Dargan standard to evaluate the finger function,17 cases got excellent results,8 good,and 1 poor.
Conclusion:It is an effective way to treat the chronic mallet finger deformity using minor bone anchors and palmaris longus tendon graft,and the method has advantages of reliable fixation,easy operation,satisfactory effect and less complication. |
| KEY WORDS Tendon injuries Internal fixators Mallet finger deformity Tendon grafting |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 彭辉煌,吴建伟,杨国敬.微型骨锚联合掌长肌腱片移植治疗陈旧性锤状指畸形[J].中国骨伤,2015,28(11):1017~1020 |
| 英文格式: | PENG Hui-huang,WU Jian-wei,YANG Guo-jing.Treatment of chronic mallet finger deformity with minor bone anchors and palmaris longus tendon graft[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(11):1017~1020 |
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