金属夹板外固定与可吸收骨锚系统治疗早期闭合性锤状指

Metal splint external fixation versus absorbable bone anchor system to treat closed mallet finger in early stage

背景:可吸收骨锚治疗锤状指是一种新型的内固定方法。目的:比较金属夹板外固定与可吸收骨锚系统治疗早期闭合性锤状指病例的临床效果。方法:早期闭合性锤状指病例40例,其中采用金属夹板外固定治疗24例,采用可吸收骨锚内固定治疗16例,受伤至给予治疗时间均为1周以内。对两组患者临床资料及手术结果进行回顾性分析,并对两组的优良率进行统计学分析。结果与结论:所有病例均获得随访4个月以上,最长随访时间14个月。参照国际手外科学会推荐的TAM系统评定法,金属夹板外固定组优良率66.7%;可吸收骨锚内固定组优良率93.8%,两组间差异有显著性意义(P<0.05),金属夹板固定组有2例分别于治疗后4个月,6个月出现复发;骨锚组有1例功能锻炼时出现局部肿痛、皮肤发红,经物理治疗后好转,表明可吸收骨锚内固定组的疗效显著优于金属夹板外固定组。可吸收骨锚系统治疗过程简单,效果肯定,是治疗早期闭合性锤状指的首选治疗方法,但其价格昂贵,未能广泛开展;金属夹板虽然操作简单,但是治疗过程中管理困难,复发率发高。

BACKGROUND： The absorbable bone anchor is a new internal fixation method. OBJECTIVE： To compare the clinical outcomes the metal splint external fixation and absorbable bone anchor system in treatment of closed mallet finger in early stage. METHODS： Forty cases of closed mallet fingers were selected, 24 cases were treated with the metal splint external fixation and 16 cases were treated with absorbable bone anchor system. The time from injury to treatment was less than 1 week. The clinical data and surgical outcomes of the patients were retrospectively analyzed, and the excellent and good rate of two groups was compared with statistical analysis. RESULTS AND CONCLUSION： All patients were followed-up for 4-14 months. Reference to the International Institute of Hand Surgery recommended TAM system, the excellent and good rate was 66.7% in the metal splint external fixation group and 93.8% in the absorbable bone anchor system group,exhibiting a significant difference between two groups （P 〈 0.05）. There were two cases of recurrence in the metal splints external fixation group, one at 4 months and the other at 6 months after treatment. There was one case of local swelling and skin redness n the absorbable bone anchor system during functional training and these symptoms were improved after physical therapy, tt indicated that the effect of the absorbable bone anchor system is significantly better than that of the metal splint external fixation. Absorbable bone anchor system is the first choice for the treatment of early closed mallet finger with the simple surgical procedure and the certain effect. However, the expensive price limits its wider application. Metal splint is easy to operate, but difficult to manage and the relapse rate is high during treatment.