指浅屈肌腱止点转位重建中央腱联合"战车支具"治疗Stanley Ⅲ型钮孔畸形  

Flexor digitorum superficialis tendon insertion transfer combined with a"Quadriga"orthosis for treating the Stanley I boutonniere deformity

作　　者：沙一帆 施海峰 杨惟翔 徐鹏 庞新岗 陆浩 吴柯 Sha Yifan;Shi Haifeng;Yang Weixiang;Xu Peng;Pang Xingang;Lu Hao;Wu Ke(Department of Hand Surgery,Wuxi Ninth People's Hospital,Wuxi 214062,China)

机构地区：[1]无锡市第九人民医院手外科,无锡214062

出　　处：《中华手外科杂志》2024年第5期454-458,共5页Chinese Journal of Hand Surgery

基　　金：“滨湖之光”医学专家团队项目。

摘　　要：目的 评估指浅屈肌腱止点转位重建中央腱联合"战车支具"治疗Stanley Ⅲ型钮孔畸形的可行性及有效性.方法 自2019年6月到2023年6月,我们共收治Stanley Ⅲ型钮孔畸形患者13例,均采用掌侧松解、指浅屈肌腱止点转位重建中央腱联合"战车支具"的综合治疗方案,术后1、2、3个月门诊随访,并测量统计其术前及术后近指间关节主动活动度、握力,近指间关节功能评分采用Steichen评分系统.结果 术后13例患者均在门诊获得3个月以上的随访,伤口均Ⅰ期愈合,近指间关节欠伸畸形外观均得到纠正,术后患指的Steichen功能评分:优7例,良4例,可1例,差1例;术前:良2例,可9例,差2例,术后较术前明显改善(P<0.05).术后患手握力为(31.2±6.2)N较术前(28.5±6.6)N明显增加(P<0.05).结论 掌侧松解、指浅屈肌腱止点转位重建中央腱联合"战车支具"的综合治疗方案治疗Stanley Ⅲ型钮孔畸形效果显著,预后较好.Objective To evaluate the feasibility and efficacy of flexor digitorum superficialis tendon insertion transfer combined witha"Quadriga"orthosis for treating the Stanley II boutonniere deformity.Methods From June 2019 to June 2023,a total of 13 patients with Stanley II boutonniere deformity received a comprehensive treatment plan of palmar release,flexor digitorum superficialis tendon insertion transfer and reconstruction of the central tendon combined with a"Quadriga"orthosis.The outpatient follow-up was conducted at 1,2,and 3 months postoperatively,and their preoperative and postoperative active range of motion and grip strength of the proximal interphalangeal joint were measured and statistically analyzed.The proximal interphalangeal joint function score was evaluated using the Steichen scoring system.Results All 13 patients were follow-up for more than 3 months in the outpatient department after surgery.The wounds achieved primary healing,and the appearance of the proximal interphalangeal joint extension deformity was corrected.The Steichen score of the affected fingers after surgery was excellent in 7 cases,good in 4 cases,fair in 1 case,poor in 1 case,and the preoperative Steichen score was good in 2 cases,fair in 9 cases,poor in 2 cases.There was a significant improvement after surgery compared to before(P<0.05).The postoperative grip strength of the affected hand(31.2±6.2)N was significantly increased compared to preoperative(28.5±6.6)N(P<0.05).Conclusion The comprehensive treatment plan of palmar release,flexor digitorum superficialis tendon insertion transfer and reconstruction of the central tendon combined with a"Quadriga"orthosis has a significant effect on the treatment of Stanley II boutonniere deformity and a good prognosis.

关 键 词：腱损伤 治疗结果 钮孔畸形 止点重建 战车支具 

分 类 号：R687.2[医药卫生—骨科学]