肱桡肌肌腱带骨块移植修复锤状指畸形  

Repairing mallet finger deformity by grafting brachioradialis tendon with bone

作　　者：古欣庆 周洋 朱红亮 李孝根 黄东 GU Xinqing;ZHOU Yang;ZHU Hongliang(The Third Department of Hand Surgery,Guangzhou Peace Orthopedic Hospital,Guangzhou,Guangdong,510317,China)

机构地区：[1]广州和平骨科医院手外三科,广东广州510317

出　　处：《实用手外科杂志》2020年第4期399-401,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨应用肱桡肌肌腱带骨块移植治疗指伸肌腱止点撕脱损伤性锤状指畸形的临床疗效。方法2016年8月-2019年11月,以肱桡肌肌腱带骨块修复Ⅰ区指伸肌腱止点撕脱损伤性锤状指畸形15例,术中将肱桡肌肌腱带骨块嵌入患指远节基底预留骨槽,以一枚0.8 mm克氏针垂直固定骨块,并中立位于远侧指间关节斜行固定一枚0.8 mm克氏针,术后保持远指间关节伸直及近指间关节微屈,石膏托或支具固定3周,术后4~6周复查X线片,根据骨块愈合情况取出内固定。术后指导患者行指间关节及掌指关节主、被动功能训练。术后定期随访。结果15例均获随访,10例门诊随访,5例微信视频随访,时间3~15个月,平均7.2个月。术后患指功能按照TAM系统评定方法进行评定,优8例,良3例,差1例,优良率92.00%。结论应用肱桡肌肌腱带骨块移植治疗Ⅰ区指伸肌腱止点撕脱锤状指畸形,操作简便,效果确切,复发率低,供区损伤小,是一种理想的治疗方法。Objective To explore the clinical effect of applying brachioradialis tendon with bone graft to treat mallet finger deformity caused by extensor tendon avulsion injury.Methods From August 2016 to March 2020,15 cases of zone I finger extensor tendon avulsion injury mallet finger deformity were repaired with brachioradialis tendon band and bone block.During the operation,brachioradialis tendon band and bone block was inserted into the disease.A bone groove is reserved at the base of the distal finger,and a 0.8 mm Kirschner wire was used to fix the bone vertically,and a 0.8 mm Kirschner wire was fixed in a neutral position at the distal interphalangeal joint.Kept the plaster support or support of the affected finger after the operation.With fixed distal interphalangeal joint straightening and proximal interphalangeal joint slightly flexed for 3 weeks,X-ray was re-examined 4-6 weeks after the operation,and the internal fixation was removed according to the bone healing.Instructed patients to exercise active and passive functional exercise of interphalangeal joints and metacarpophalangeal joints after operation.Followed up regularly after surgery.Results All 15 patients were followed up,10 outpatient visit,and 5 WeChat video follow-ups.The duration was 3-15 months,with an average of 7.2 months.The postoperative finger function was evaluated according to the TAM system evaluation method.9 cases were excellent,4 cases were good,and 2 cases were poor.The excellent and good rate was 87.00%.Conclusion The application of brachioradialis tendon with bone block transplantation to treat area I finger extensor tendon avulsion mallet finger deformity has the advantages of simple operation,accurate effect,low recurrence rate,small donor site injury,is an ideal treatment method.

关 键 词：锤状指 伸肌腱止点撕脱 肱桡肌肌腱带骨块 肌腱移植 

分 类 号：R658.2[医药卫生—外科学]