三种手术方式治疗DoyleⅠa型陈旧性锤状指畸形的效果比较  

Clinical effect comparison of three different operative methods for treatment of chronic Doyle typeⅠa mallet finger

作　　者：齐保闯[1] 徐显春[1] 邱宇[1] 贾琳[1] QI Baochuang;XU Xianchun;QIU Yu;JIA Lin(the First Department of Orthopaedics,the First People′s Hospital of Yibin,Sichuan Province,Yibin644000,China)

机构地区：[1]四川省宜宾市第一人民医院骨一科

出　　处：《中国医药导报》2019年第30期77-80,共4页China Medical Herald

基　　金：四川省卫生与计划生育委员会科研课题（17PJ199）

摘　　要：目的比较肌腱止点重建、皮肤紧缩缝合及远侧指间关节融合治疗陈旧性DoyleⅠa型锤状指畸形的临床效果。方法回顾分析2007年5月~2017年2月四川省宜宾市第一人民医院骨一科81例陈旧性DoyleⅠa型锤状指畸形的住院患者临床资料。根据患者选择的治疗方式分成重建组(40例)、紧缩组(27例)、融合组(14例)。术后随访12个月,比较三组间基本情况、手术及住院的一般情况、患指Dargan功能评价、手功能Carroll评分、视觉模拟疼痛评分(VAS)及患者主观满意度评价等。结果紧缩组手术时间、住院费用低于重建组和融合组,差异有统计学意义(P<0.05)。三组患者住院时间、并发症总发生率比较,差异无统计学意义(P>0.05)。融合组术后12个月,Dargan功能评价优良率明显低于重建组和紧缩组,差异有统计学意义(P<0.05)。三组患者的Carroll手功能评分、VAS疼痛评分及患者满意度优良率比较,差异无统计学意义(P>0.05)。结论三种手术方式均能达到患者较高的满意度及手的功能,均可用于治疗陈旧性锤状指畸形,需要依据病情及患者对治疗的要求合理选择。Objective To compare the clinical effect among reconstruction of tendon insertion,skin tightening suture and distal interphalangeal joint fusion in the treatment of chronic Doyle typeⅠa mallet fingers.Methods A retrospective analysis was conducted on the clinical data of 81 patients with chronic Doyle typeⅠa mallet fingers treated in the First Department of Orthopaedics of the First People′s Hospital of Yibin in Sichuan Province from May 2007 to February 2017.The patients were divided into reconstruction group(40 cases),tightening suture group(27 cases)and fusion group(14 cases)base on the treatment method selected by the patients.They were followed up for 12 months.The basic conditions,general conditions of surgery and hospitalization,Dargan function evaluation of the affected fingers,Carroll scoring of hand functions,the visual analog scale(VAS)and subjective satisfaction evaluation of patients were compared among the three groups.Results The duration of operation,and the hospitalization cost of tightening suture group were lower than those of the reconstruction group and the fusion group,and the differences were statistically significant(P<0.05).There were no significant differences in the hospitalization time and the total incidence of complications among the three groups(P>0.05).Twelve months after operation,the excellent and good rate of Dargan function evaluation in the fusion group was significantly lower than that in the reconstruction group and the tightening suture group,and the difference was statistically significant(P<0.05).There were no significant differences in Carroll scores,VAS scores and the excellent and good rate of patients′satisfaction among the three groups(P>0.05).Conclusion All the three surgical methods are available to achieve high patient satisfaction and good hand functions,and can be used for the treatment of chronic mallet fingers.However,reasonable selection should be made according to the condition and patients′requirements for treatment.

关 键 词：锤状指 手术治疗 陈旧性 疗效 

分 类 号：R682.5[医药卫生—骨科学]