微型锚钉结合克氏针固定治疗锤状指的疗效分析

Therapeutic effect of micro-anchor repair combined with Kirschner wire fixation in the treatment of mallet fingers

目的探讨微型锚钉结合克氏针固定治疗锤状指的临床疗效。方法2010年6月～2011年3月，对我院收治的16例锤状指患者采用微型锚钉结合克氏针固定的手术方法治疗。受伤至手术时间（13．5±6．4）d，其中4例受伤后1月余行手术治疗，属陈旧性损伤患者。术后不用外固定，6周后拔除克氏针开始功能锻炼。结果16例患者切口均I期愈合，无并发症发生。16例均获随访，随访时间6～12个月。末次随访时，根据Crawford功能评定方法，新鲜损伤组12例患者优9例，良3例，优良率100％，DIP关节活动度（67．9±9．2）°；陈旧性损伤组4例患者良3例，可1例，优良率75％，DIP关节活动度（53．8±15．3）°。统计结果显示新鲜损伤组患者术后关节活动度及疗效均明显优于陈旧性损伤组患者，其差异具有显著性（P〈0．05）。结论采用微型锚钉结合克氏针固定治疗锤状指是一种简便、有效的方法。

Objective To evaluate the clinical efficacy of micro-anchor repair combined with Kirschner wire fixation in the treatment of mallet fingers. Methods From June 2010 to March 2011, 16 patients with mallet fingers were treated by micro-anchor repair combined with Kirschner wire fixation in our hospital. The duration of the deformity before pre- sentation were （13.5 ± 5.4） days. Among them, 4 patients were chronic mallet finger deformity （〉 1 months after the injury）. No external fixation was used postoperatively. The Kirschner wire was removed 6 weeks after operation, then functional exercises were performed. Results All the patients obtained healing of incision by first intention and were followed up for 6-12 months （8.3 months on average）. According to the Crawford functional assessment system, the results were excellent in 9 cases, good in 3 cases at the final follow-up with an excellent and good rate of 100% in the fresh mallet fingers group, and the range of motion of the DIP joints were （67.9 ± 9.2）° on average. The results were good in 3 cases, fair in 1 case with an excellent and good rate of 75% in the chronic mallet fingers group, and the range of motion of the DIP joints were （53.8 ±15.3） ° on average. There were significant difference between two groups in the excellent and good rate and the range of motion of the DIP joints （P 〈 0.05）. Conclusion Micro-anchor repair com- bined with Kirschner wire fixation is simple and effective in the treatment of mallet finger.