微型锚钉治疗陈旧性锤状指畸形的疗效分析

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1、微型锚钉治疗陈旧性锤状指畸形的疗效分析【摘要】　　［目的］介绍一种应用微型锚钉治疗陈旧性锤状指畸形的方法，通过观察临床效果来探讨该方法治疗陈旧性锤状指畸形的可行性。［方法］对14例陈旧性锤状指患者临床应用微型锚钉治疗。于远侧指间关节（DIP）背侧做“и”形切口，显露伸指肌腱，将断端间疤痕切除，用1枚1mm克氏针将远侧指间关节（DIP）固定于伸直位，用肌腱缝合线水平褥式缝合伸指肌腱断端，于末节指骨基底背侧钻孔后安装微型锚钉，将锚钉尾部携带的肌腱缝线与伸指肌腱近断端缝合以加强缝合强度。术后前臂掌侧面石膏托固定腕关节

2、背神30°，掌指关节及指间关节伸直位3周，6周后拔除克氏针开始功能锻炼。［结果］随访6个月～1年，按Dargan功能评定法：优10例，良2例，可1例，差1例。其中1例远侧指间关节（DIP）屈曲功能障碍，无畸形复发。优良率85.7％。［结论］应用微型锚钉治疗陈旧性锤状指畸形具有缝合强度高，畸形复发率低，操作简便，效果可靠的优点，是一种治疗陈旧性锤状指畸形简便有效的方法。【关键词】微型锚钉锤状指畸形矫治　　Therapeuticeffectofmicroanchorinchronicmalletfingerdef

3、ormity　　Abstract：［Objective］TointroducethemethodoftreatingchronicmalletfingerusingMicroArcboneAnchor,and9investigatethefeasibilityofthismethodwiththeclinicaleffects.［Method］FourteenchronicmalletfingersweretreatedwithMicroArcboneAnchors.Duringtheoperation,a"и

4、"skinincisionoverthedorsumoftheDIPjointwasmadetoexposetheextensortendonandresectthescartissuebetweenthedisruptedends.ThentheDIPjointwasmadeatextendingpositionwasimmobilizedwitha1mmKirschnerwireandtheendsofextensortendonwassuturedwithhorizontalmattresssuturem

5、ethod.Afterthat,theMicroArcboneAnchorwassuturedintothedorsalbaseofthedistalphalanx,thesuturethreadattachedtheendofanchorwastiedtotheproximalendoftheextensortendontoreinforcetheformersuture.Externalfixationontheanteriorfaceofforearmwasappliedtoimmobilizethewr

6、istat30°ofextentionandthemetacarpophalangealandinterphalangealjointsandextendingpositionfor3w,andKirschnerwirefixationwastakenout6wpostoperatively.FunctionalexerciseswereperformedaftertheKirschnerwireswereremoved.［Result］Allthecaseswerefollowedupfor6monthsto

7、1year,andexcellentresultswereobtainedin10cases,goodin2,fairin2andpoorin1accordingtoDargan'sfunctionalassessmentsystem,withdysfunctionofflexioninDIPjointin1case,andrecurrenceofabnormityin1case.Thetotalrateof9excellentandgoodresultswas85.7％.［Conclusion］MicroAr

8、cboneAnchorisaconvenientandeffectivealternativeforthetreatmentofchronicmalletfingerdeformitywithmanyadvantagessuchasthehighsuturingintensity,lowrecurrencerateofabnormity,convenientforoperationan