B型超声引导经皮伸指肌腱止点重建治疗腱性锤状指  

B-mode ultrasound guided percutaneous extensor tendon reconstruction for the treatment of tendon mallet fingers

作　　者：王朝亮 黄素芳 蔺伟 康颂科 高博 孙雪生 Wang Chaoliang;Huang Sufang;Lin Wei;Kang Songke;Gao Bo;Sun Xuesheng(Department of Hand Surgery,Jinan People’s Hospital,Jinan 271199,China)

机构地区：[1]济南市人民医院手外科,济南271199

出　　处：《中华整形外科杂志》2022年第8期905-910,共6页Chinese Journal of Plastic Surgery

摘　　要：目的探讨B型超声引导经皮伸指肌腱止点重建治疗腱性锤状指的临床疗效。方法回顾性分析2010年2月至2019年1月济南市人民医院手外科收治的腱性锤状指畸形患者临床资料,患者均行B型超声引导经皮重建伸指肌腱止点的微创治疗。在B型超声引导下以PDSⅡ单丝缝合线经皮缝合伸指肌腱,向末节指骨基底牵拉,在末节指骨基底以直径1.0 mm克氏针钻孔,行伸肌腱止点重建。术后观察患指主动、被动伸直角度,伤口愈合情况,采用Crawford法评估手指功能。治疗前后比较采用配对t检验。P<0.05为差异有统计学意义。结果共纳入58例,男48例,女10例,年龄20~53岁。49例患者术后获6~15个月随访,平均11个月,9例失访。至末次随访时,患指主动伸直角度由术前的46.5°±7.2°,改变到术后的6.4°±0.5°,术前后比较差异有统计学意义(t=38.89,P<0.001);被动伸直角度由术前的3.2°±0.3°,降至术后的0.9°±0.2°,术前后比较差异有统计学意义(t=44.65,P<0.001)。术后未发生线结外露、皮肤坏死等并发症。Crawford法评估手指功能:优29例,良12例,可8例。结论B型超声引导经皮伸指肌腱止点重建治疗腱性锤状指,手术损伤小,功能恢复良好,效果满意。Objective To investigate the clinical efficacy of B-mode ultrasound guided percutaneous extensor tendon insertion reconstruction in the treatment of tendinous mallet fingers.Methods A retrospective analysis was performed on the data of patients with mallet finger deformity admitted to the Department of Hand Surgery of Jinan People’s Hospital from February 2010 to January 2019.Under the guidance of B-mode ultrasound,the extensor tendon was sutured percutaneously with PDS II monofilament suture,pulled to the base of the distal phalanx,which was drilled with a 1.0 mm Kirschner’s wire to reconstruct the insertion of the extensor tendon.The active and passive extension angles of the affected fingers and the wound healing were observed after operation.Evaluation of finger function using Crawford’s method.Results A total of 58 cases were enrolled,including 48 males and 10 females,aged 20-53 years.49 patients were followed up for 6 to 15 months after operation,with an average of 11 months,and 9 patients were lost to follow-up.The active extension angle of the affected finger changed from 46.5°±7.2°before operation to 6.4°±0.5°after operation,and the difference was statistically significant before and after operation(t=38.89,P<0.001).The passive extension angle decreased from 3.2°±0.3°before operation to 0.9°±0.2°after operation,and the difference was statistically significant before and after operation(t=44.65,P<0.001).There were no complications such as exposed knots and skin necrosis.Evaluation by Crawford method:excellent in 29 cases,good in 12 cases,and fair in 8 cases.Conclusions Percutaneous ultrasound-guided extensor finger tendon insertion reconstruction,minimally invasive surgery,in the treatment of tendon mallet finger function recovered well,and the effect was satisfactory.

关 键 词：B型超声 经皮微创技术 锤状指 伸肌腱 

分 类 号：R687.2[医药卫生—骨科学]