克氏针弹性固定手指伸肌腱止点撕脱骨折的疗效分析  

Curative Effect Analysis of Kirschner's Needle Elastic Fixation of Extensor Tendon Avulsion Fracture of Finger

作　　者：苗杰 夏晓明 朱乾彬 王嘉龄 MIAO Jie;XIA Xiaoming;ZHU Qianbin;WANG Jiaing(Department of Hand Surgery,Yixing Second People´s Hospital,Yixing,Jiangsu Province,214221 China)

机构地区：[1]宜兴市第二人民医院手外科,江苏宜兴214221

出　　处：《世界复合医学》2022年第11期128-131,共4页World Journal of Complex Medicine

摘　　要：目的探究应用克氏针弹性固定手指伸肌腱止点对撕脱骨折的疗效。方法对2019年4月—2021年5月期间宜兴市第二人民医院收治的45例手指伸肌腱止点撕脱骨折(锤状指)患者的临床资料展开回顾性分析。根据手术治疗方式进行分组,A组24例,采用克氏针弹性固定手指伸肌腱止点;B组21例,采用常规克氏针直接固定。记录术后两组患指围术期相关指标、TAM评定情况、活动度及并发症发生情况。结果A组患指平均骨性愈合时间为(38.87±4.25)d,显著短于B组的(42.35±5.12)d,差异有统计学意义(t=2.491,P<0.05);A组术后患指疼痛视觉模拟评分(VAS)为(3.06±1.02)分,明显低于B组评分的(4.57±1.78)分,差异有统计学意义(t=3.547,P<0.05);A组患指术后关节活动度为(42.97±2.45)º,较B组的(37.64±3.12)º更大,差异有统计学意义(t=6.412,P<0.05);A组患指并发症发生率12.50%低于B组33.33%,差异无统计学意义(χ^(2)=1.736,P>0.05);A组术后手指总主动活动度(TAM)功能优良率91.67%较B组71.43%更佳,差异有统计学意义(Z=2.002,P<0.05)。结论克氏针弹性固定治疗锤状指较常规克氏针直接固定方法能够有效纠正锤状指畸形,修复指伸肌腱,利于手指屈伸功能恢复。Objective To explore the efficacy of Kirschner's needle elastic fixation finger extensor tendon insertion to avulsion fracture.Methods The clinical data of 45 patients with avulsion fracture of extensor tendon insertion(hammer finger)in Yixing Second People's Hospital from April 2019 to May 2021 were analyzed retrospectively.According to the surgical treatment,24 patients in group A were treated with Kirschner's needle elastic fixation of extensor tendon insertion;in group B,21 patients were directly fixed with conventional Kirschner's needle.Perioperative relevant indexes,TAM assessment,range of motion and complications were recorded in the two groups after surgery.Results The average bone healing time of the affected finger in group A was(38.87±4.25)d,which was shorter than that in group B[(42.35±5.12)d],and the difference was statistically significant(t=2.491,P<0.05).The Visual Analogue Score(VAS)of postoperative finger pain in group A was(3.06±1.02)points,which was lower than that in group B[(4.57±1.78)points],and the difference was statistically significant(t=3.547,P<0.05).The postoperative range of motion of the affected finger in group A was(42.97±2.45)°,which was greater than that in group B[(37.64±3.12)°],and the difference was statistically significant(t=6.412,P<0.05).The incidence of complications in group A(12.50%)was lower than that in group B(33.33%),and the difference was not statistically significant(χ^(2)=1.736,P>0.05).The excellent and good rate of total active motion(TAM)function in group A was 91.67%,which was better than that in group B(71.43%),and the difference was statistically significant(Z=2.002,P<0.05).Conclusion The treatment of hammer finger by elastic fixation with Kirschner's needle can effectively correct the deformity of hammer finger,repair the tendon of finger extension,and facilitate the recovery of finger flexion and extension function than the conventional direct fixation method with Kirschner's needle.

关 键 词：克氏针 弹性固定 锤状指 指伸肌腱 屈伸功能 

分 类 号：R687.2[医药卫生—骨科学]