延长指背腱膜中央束治疗锤状指

Treatment of mallet fingers by lengthening of central slip of the extensor apparatus

目的介绍应用延长指背腱膜中央束治疗锤状指的方法和疗效。方法对16例锤状指患者,在手指近节中央束作“Z”形延长,断端用5-0肌腱缝线做重叠褥式缝合,使中央束延长了3～5mm。术后掌指关节石膏托休息位固定,患指夹板固定近侧指间关节屈曲30°～40°,远侧指间关节背伸10°～15°位,4周后去除外固定进行功能锻炼。结果术后随访4个月～3年,平均20个月。采用Dargan功能评定法:优12例,良2例,优良率达87.5%。结论采用延长指背腱膜中央束治疗锤状指,操作简单,疗效可靠。

Objective To introduce the method of central slip lengthening for management of mallet fingers, and evaluate the treatment outcome. Methods 16 cases of mallet fingers were treated with this procedure. A Z-shaped incision was made on the central slip of the extensor apparatus. The tendon was cut, self-lengthened, and re-attached by mattress suture with '5-0'tendon sutures. The central slip was lengthened for 3 mm to 5 mm. Postoperative immobilization of the finger in a plaster kept the metacarpophalangeal joint in rest position, the proximal interphalangeal joint in 30° - 40° flexion, and the distal interphalangeal joint in 10°- 15° extension for 4 weeks. Rehabilitation started after the plaster was removed. Results Postoperative follow up ranged from 4 months to 3 years, with an average of 20 months. According to Dargan criteria, the overall effective rate was 87.5%. Excellent result was obtained in 12 cases and good in 2 cases. Conclusion Lengthening of central slip of the extensor apparatus is an easy and effective method for treatment of mallet fingers.