掌长肌腱转移治疗陈旧性锤状指畸形  

PALMARIS LONGUS TENDON GRAFT FOR TREATMENT OF OLD MALLET FINGER DEFORMITY

作　　者：张智[1] 吴晓满[1] 陆俊峰[1] 赵东升[1] 

机构地区：[1]解放军第309医院骨科北京,100091

出　　处：《中国修复重建外科杂志》2013年第6期726-728,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨掌长肌腱转移重建伸肌腱终腱止点治疗陈旧性锤状指畸形的疗效。方法 2009年2月-2011年2月,采用掌长肌腱转移重建伸肌腱终腱止点治疗32例陈旧性锤状指畸形患者。男28例,女4例;年龄22～58岁,平均32.5岁。致伤原因:运动伤26例,戳伤6例。损伤指别:示指8例,中指3例,环指16例,小指5例。按Rockwell等分型标准均为Ⅰ型。受伤至手术时间为4～16周,平均6周。结果术后切口均Ⅰ期愈合,无皮肤坏死、感染及甲床损伤等并发症发生。32例均获随访,随访时间12～20个月,平均14个月。指腹侧均无疼痛及感觉异常。末次随访时,根据Patel等锤状指疗效评价标准评定:优8例,良21例,中2例,差1例,优良率为90.6%。结论采用掌长肌腱转移重建伸肌腱终腱止点是治疗陈旧性锤状指畸形的一种有效方法。Objective To investigate the effectiveness of the terminal extensor tendon reconstrution by palmaris longus tendon graft for the treatment of old mallet finger deformity.Methods Between February 2009 and February 2011,32 patients with old mallet finger deformity were treated with palmaris longus tendon graft.There were 28 males and 4 females with an average age of 32.5 years（range,22-58 years）.The injury causes included sports injury in 26 cases and punctured injury in 6 cases.The index finger was involved in 8 cases,the middle finger in 3 cases,the ring finger in 16 cases,and the little finger in 5 cases.According to the Rockwell＇s classification,all patients were classified as type I.The time from injury to operation was 4-16 weeks（mean,6 weeks）.Results Primary healing was obtained in all incisions;no necrosis,infection,or nail bed injury occurred.All patients were followed up 12-20 months（mean,14 months）.The patients had no pain or paresthesia of volar finger.According to Patel＇s functional assessment system,the results were excellent in 8 cases,good in 21 cases,fair in 2 cases,and poor in 1 case at last follow-up,with an excellent and good rate of 90.6%.Conclusion Reconstruction of the terminal extensor tendon by palmaris longus tendon graft is a reliable method to treat old mallet finger deformity.

关 键 词：陈旧性锤状指畸形 掌长肌腱 肌腱转移术 

分 类 号：R687.3[医药卫生—骨科学]