钢丝横穿末节指骨法治疗锤状指的临床疗效  

Clinical observation and effect of steel wire crossing the distal phalanx in the treatment of hammer finger

作　　者：李延涛 LI Yantao(Department Hand and Foot Surgery,Zibo Orthopedic Hospital,Zibo,Shandong,255000,China)

机构地区：[1]淄博市骨科医院手足外科,山东淄博255000

出　　处：《实用手外科杂志》2022年第2期234-236,共3页Journal of Practical Hand Surgery

摘　　要：目的 探讨应用钢丝横穿末节指骨法治疗锤状指的临床疗效。方法 回顾性分析2017年2月-2018年11月收治的45例锤状指患者临床资料,其中骨性锤状指36例,腱性锤状指9例。根据杜冬锤状指分型法,Ⅰ型10例、Ⅱ型23例、Ⅲ型7例、Ⅳ5例。术中采用1.0 mm克氏针呈背伸5°~10°纵穿固定远指间关节,末节指骨基底钻孔做骨性隧道,0.3 mm钢丝横穿末节指骨基底,复位加压固定骨折块。观察术后并发症发生情况及手指功能恢复情况。结果 术后对45例进行6~24个月随访,切口均一期愈合,无切口感染、肌腱二次断裂等并发症发生。末次随访经X线片检查所有病例全部骨性愈合、骨折复位良好、关节面平整。依据手指总主动活动度评定法(TAM)进行评定,优36例,良9例,优良率为100%。结论 钢丝横穿末节指骨法治疗锤状指具有手术操作简单、固定可靠、并发症少、费用低等优点。患者术后功能恢复良好,疗效满意,值得临床推广应用。Objective To investigate the clinical effect of steel wire crossing the distal phalanx in the treatment of hammer finger. Methods The clinical data of 45 patients with hammer finger treated from February 2017 to November 2018 were analyzed retrospectively, including 36 cases of bone hammer finger and 9 cases of tendon hammer finger. According to Du Dong’s hammer finger typing, there were10 cases of type Ⅰ, 23 cases of type Ⅱ, 7 cases of type Ⅲ and 5 cases of type Ⅳ. During the operation,the distal interphalangeal joint(DIP) was fixed by 1.0mm Kirschner wire with a back extension of 5 ° ~10 °, the distal phalangeal base was drilled as a bone tunnel, 0.3mm steel wire crossed the distal phalangeal base, and the fracture block was reduced and fixed. The postoperative complications and the recovery of finger function were observed. Results 45 patients were followed up for 6 to 24 months. All the incisions healed in one stage, and there were no complications such as incision infection, tendon rupture. X-ray examination at the last follow-up showed that all achieved bone healing, good fracture reduction and smooth articular surface. According to TAM, 36 cases were excellent and 9 cases were good. The excellent and good rate was 100%. Conclusion The method of steel wire crossing the distal phalanx in the treatment of hammer finger has the advantages of simple operation, firmer fixation, less complications and low cost. The patients have good postoperative functional recovery and are satisfied with the treatment effect. It is worthy of clinical application.

关 键 词：锤状指 钢丝 骨隧道 横穿指骨 

分 类 号：R687.3[医药卫生—骨科学]