伸肌腱止点重建治疗锤状指畸形  

Treatment of mallet fingers by reconstruction insertion of extensor tendon

作　　者：庄加川[1] 张振伟[1] 廖坚文[1] 殷明天[1] 陈乐锋[1] 陈国荣[1] 余少校[1] 关助明[1] 

机构地区：[1]深圳市手外科治疗康复中心深圳市沙井人民医院手外科,广东深圳518104

出　　处：《实用手外科杂志》2005年第3期139-140,共2页Journal of Practical Hand Surgery

摘　　要：目的介绍应用重建伸肌腱止点治疗锤状指畸形的方法和疗效。方法对13例锤状指患者,于末节指骨终腱止点处作粗糙面熏取掌长肌腱游离移植。肌腱近端用3/0缝合线重叠缝合,远端用4/0丝线作“8”字缝合后绕行至指端皮肤外打结。远侧指间关节用直径1.0mm克氏针固定过伸位10°～15°,近侧指间关节石膏托固定屈曲位30°～40°。4周后拆除牵引线及外固定进行近侧指间关节及掌指关节功能锻炼,6周后拔除克氏针进行末节屈伸功能锻炼。结果随访2个月～2年,按Dargan功能评定法:优11例,良1例,可1例,优良率92.3%。结论伸肌腱止点重建术是治疗锤状指畸形的有效方法。Objective To introduce the method of insertion of extensor apparatus reconstruction for management of mallet fingers, and evaluate its treatment outcome,Methods Thirteen cases with mallet fingers were treated by this procedure. A roughness face was made at the site of insertion in distal phalanx, the palmaris longus was used as a flee graft, The near end of broken tendons were sutured with 3/0 tendon suture needle, whereas the distal end of tendons were sutured “8”means with 4 silk thread, and the holding thread was passed through the distal phalanx, which was tied over the palmar digital tip skin. The proximal interphalangeal joint in 30～40 degrees flexion with plaster and the distal interphalangeal joint in 10-15 degrees extension by 1,0mm diameter Keith needle. Movement of the proximal interphalangeal joint and metacarpophalangeal joint could be performed when the fixator and the suture was removed after 4 weeks, function practice of the distal phalanx could be performed when the Keith needle was removed after 6 weeks. Resdts Postoperative follow tlp ranged from 2 months to 2 years, with an average of 20 months. According to Dargan criteria, the overall effective rate was 92.3%.Excellent result was obtained in 11 cases, good in 1 case. Conclusion Reconstruction insertion of extensor tendon is an effective method to treat mallet fingers.

关 键 词：腱损伤 锤状指 外科手术 

分 类 号：R687[医药卫生—骨科学]