单外侧腱移位治疗手指钮孔畸形的解剖及临床研究

Anatomy and clinical significance of treatment of boutonniere deformity by translocationing one lateral tendon

目的介绍应用单外侧腱移位治疗手指钮孔畸形的方法和疗效。方法对14例14指钮孔畸形患者,在手指近侧指间关节侧方作弧形切口,将一侧外侧腱于关节囊水平切断,移位与损伤的中央束近端用5-0肌腱缝线做水平褥式缝合。术后掌指关节石膏托休息位固定,患指用夹板固定近侧指间关节伸直位,远侧指间关节屈曲位,4周后去除外固定进行功能锻炼。结果随访4个月～2年,平均14个月。14例患指近侧指间关节伸直受限5°～15°,平均改善30°～40°,钮孔畸形得到矫正。结论采用单外侧腱移位治疗手指钮孔畸形,操作简单,疗效可靠。

Objective To introduce and evaluate treatment outcome and method of boutonniere deformity translocationing one lateral band of extensor apparatus.Methods In 14 boutonniere deformity patients, a radian incision was made in the proximal interphalangeal, one lateral band was cut on the joint capsule, the band was translocationed and sutured to the distally broken insertion site of the central slip of the extensor with 5-0 tendon suture needle by mattress suture. Then the metacarpophalangeal were fixed rest position with plaster, the PIP joints were fixed straighten and the DIP joints were fixed flexion with splint. Movement of the involved finger can be performed when the fixator is removed after 4 weeks. Results Postoperative follow up ranged from four months to two years, with an average of fourteen months, the PIP joints extended limitation to 5°-15°,average improve 30°-40° ,the boutonniere deformity was corrected. Conclusion It is easy and effective to treat boutonniere deformity by translocationing one lateral band.