显微精细修复结合微型锚钉对WehbeⅠa、Ⅰb型锤状指患者关节功能、炎性介质和并发症影响  

Effect of Microfine Repair Combined with Micro Anchor Nails on Joint Function, Inflammatory Mediators, and Complications in Patients with Wehbe Type Ⅰa and Ⅰb Hammertoes

作　　者：王清涛[1] 高新梅 王宝石[1] 李广章[1] 李岩 韩旭 刘小坡 WANG Qingtao;GAO Xinmei;WANG Baoshi;LI Guangzhang;LI Yan;HAN Xu;LIU Xiaopo(Department of Hand and Foot Surgery,the First Hospital of Qinhuangdao City,Qinhuangdao,Hebei 066000,China;the Third Department of Orthopaedics,Tangshan Workers'Hospital,Tangshan,063000 Hebei,China)

机构地区：[1]秦皇岛市第一医院手足外科,河北秦皇岛066000 [2]唐山市工人医院骨三科,河北唐山063000

出　　处：《临床误诊误治》2023年第6期94-98,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省医学科学研究课题计划(20210326);秦皇岛科技局自筹经费项目(201902A151)。

摘　　要：目的 探讨显微精细修复结合微型锚钉对WehbeⅠa、Ⅰb型锤状指患者关节功能、炎性介质和并发症的影响。方法 选取2019年1月—2022年1月收治的WehbeⅠa、Ⅰb型锤状指100例,根据手术方法不同将其分为研究组(51例)和对照组(49例)2组。研究组采用显微精细修复结合微型锚钉治疗,对照组采用克氏针联合肌腱缝合治疗。比较2组手术时间、住院时间、治疗费用,术后3个月关节功能和远侧指间关节(DIP)活动功能,术前和术后7 d炎性介质,以及术后2周伤口愈合和术后3个月内并发症情况。结果 研究组手术时间长于对照组,治疗费用高于对照组,但住院时间短于对照组(P<0.01)。术后3个月,研究组关节功能优良率高于对照组,DIP活动度和屈曲度大于对照组(P<0.05,P<0.01)。术后7 d,血清白细胞介素-2、白细胞介素-1β和C反应蛋白2组均低于术前,且研究组低于对照组(P<0.01)。术后2周,2组伤口均甲级愈合。术后3个月内,研究组并发症发生率低于对照组(P<0.05)。结论 显微精细修复结合微型锚钉治疗WehbeⅠa、Ⅰb型锤状指患者可改善关节功能和DIP活动功能,降低炎性介质水平,促进患者康复,且术后并发症少。Objective To investigate the effects of microfine repair combined with micro anchor nails on joint function,inflammatory medⅠators,and complications in patients with Wehbe typeⅠa andⅠb hammertoes.Methods The clinical data of 100 patients with Wehbe typeⅠa andⅠb hammertoes in our hospital from January 2019 to January 2022 were collected.The patients were grouped according to different surgical methods,in which 49 patients were treated with kerfing needle combined with tendon suture as the control group and 51 patients were treated with micro-fine repair combined with micro anchor nail as the research group.The duration of operation,length of hospital stay,treatment expenses,joint function and mobility function of distal interphalangeal joint(DIP)at 3 months after surgery,serum inflammatory medⅠators levels before surgery and at 7 d after surgery,wound healing at 2 weeks after surgery,and complications at 3 months after surgery were compared between the two groups.Results The duration of operation was longer in the research group than in the control group,and the treatment expenses were higher than those in the control group,but the length of hospital stay was shorter than in the control group(P<0.05).The good and excellent rate of joint function was higher in the research group than in the control group(P<0.05),and the DIP mobility and flexion were greater in the research group than in the control group at 3 months after surgery(P<0.05,P<0.01).The serum interleukin-2(IL-2),interleukin-1β(IL-1β),and C-reactive protein(CRP)levels were significantly lower than those before surgery in both groups,and lower in the research group than in the control group(P<0.05).The grade A healing of wounds in both groups was achieved at 2 weeks after surgery,and the complication rate within 3 months after surgery was lower in the research group than in the control group(P<0.05).Conclusion In the treatment of patients with Wehbe typeⅠa andⅠb hammertoe,micro-fine repair combined with micro anchor nails can improve joi

关 键 词：锤状指 显微精细修复 微型锚钉 关节功能 白细胞介素-2 白细胞介素-1β C反应蛋白 并发症 

分 类 号：R682.15[医药卫生—骨科学]