Thompson法与抽出钢丝法重建伸肌腱止点治疗陈旧性锤状指的效果比较  

Effect comparison of the Thompson method and wire-pulling out method for reconstruction of the terminal of extensor tendon in the treatment of old mallet finger

作　　者：刘斌 胡学斌 陶红波 刘燕芹 何成洁 金东 LIU Bin;HU Xue-bin;TAO Hong-bo;LIU Yan-qin;HE Cheng-jie;JIN Dong(Department of Orthopedics,Wuhan Wudong Hospital,Hubei Province,Wuhan430064,China)

机构地区：[1]武汉市武东医院骨科,湖北武汉430064

出　　处：《中国当代医药》2020年第23期88-91,共4页China Modern Medicine

摘　　要：目的评价应用Thompson法及抽出钢丝法重建伸肌腱止点治疗陈旧性锤状指的临床效果。方法收集2012年6月~2016年6月武汉市武东医院外科收治的40例陈旧性锤状指患者作为研究对象,按照不同治疗方法将其分为两组,应用Thompson法治疗锤状指20例(为A组),应用抽出钢丝法重建伸肌腱止点治疗20例(B组),比较两种手术方法的治疗效果。结果A组16例患者得到术后6个月的随访,按TAM系统评定方法,优8例,良6例,可2例,差0例,优良率为87.5%。B组18例患者得到术后6个月的随访,按TAM系统评定方法,优4例,良5例,可4例,差5例,优良率为50.0%。A组术后有2例患者皮下有异物形成,并发症总发生率为12.5%;B组术后有4例患者切口或指腹部皮肤坏死,4例患者皮下有异物形成,并发症总发生率为44.4%。A组锤状指复发患者0例,复发率为0.0%;B组锤状指复发患者4例,复发率为22.2%。A组的功能优良率高于B组,并发症总发生率、锤状指复发率均低于B组,差异有统计学意义(P<0.05)。结论应用Thompson法治疗锤状指,患者复发率低,并发症少,且能纠正鹅颈畸形,疗效满意。Objective To evaluate the clinical effect of Thompson method and wire-pulling out method for reconstruction of the terminal of extensor tendon in treating old wallet finger.Methods A total of 40 patients with old mallet finger admitted into the Department of Surgery of the Wuhan Wudong Hospital from June 2012 to June 2016 were collected as research objects,and they were divided into two groups according to different treatment methods.Thompson method was used to treat 20 cases of mallet finger(group A),other 20 cases(group B)were treated with wire-pulling out method to reconstruct the terminal of extensor tendon,and the therapeutic effect of the two surgical methods were compared.Results In group A,16 cases were followed up for 6 months after surgery,according to the TAM functional assessment system,8 cases were excellent,6 good,2 fair,and 0 poor,the excellent and good rate was 87.5%.In group B,18 cases were followed up for 6 months after surgery,according to the TAM functional assessment system,4 cases were excellent,5 good,4 fair,5 poor,the excellent and good rate was 50.0%.In group A,2 patients had foreign body formation under the skin after surgery,and the total incidence of complications was 12.5%.In group B,4 patients had skin necrosis of incision or finger pulp after surgery,4 patients had foreign body formation under the skin,and the total incidence of complications was 44.4%.No one had a relapse of mallet finger in group A,and the recurrence rate was 0.0%;4 patients had a relapse of mallet finger in group B,and the recurrence rate was 22.2%.The excellent and good function rate in group A was higher than that in group B,and the total incidence of complications and recurrence of mallet finger were lower than those in group B,the differences were statistically significant(P<0.05).Conclusion Adopting Thompson method to treat mallet finger has a low recurrence rate and fewer complications,and can correct swan-neck deformity with satisfactory effect.

关 键 词：伸肌腱 陈旧性锤状指 Thompson法 抽出钢丝法 疗效比较 

分 类 号：R658.2[医药卫生—外科学]