ORTHOFIX微型外固定支架闭合矫正先天性近指间关节屈曲畸形

Closed ORTHOFIX Mini - external Fixator Correction of Congenital PIP Joint Flexion Deformity

目的：探讨ORTHOFIX微型外固定支架闭合矫正先天性近指间（HP）关节屈曲畸形的临床效果。方法：2009年6月至2011年7月，我院收治先天性PIP关节屈曲畸形6例6指。其中左手环指2例，右手小指4例。6例均为Ⅱ型，PIP关节屈曲挛缩角度为71．5°～92．5°，平均85．7°±1．3°。均使用ORTHOFIX微型外固定支架闭合矫正。根据TAM系统评定方法评价疗效。结果：本组6例6指，经过2．5～4周（平均3周）治疗，屈曲挛缩关节完全伸直，术后4周测量PIP关节角度为160．2°～179．5°，平均176．7°±0．8°，平均矫正91．0°±1．3°。术后1月根据TAM系统评定方法评定疗效，优5例，良1例。患者均获随访0．5～2a，仅1例患者术后1a手指PIP关节角度只达160°，有部分关节活动度丢失，其余5例患者患指PIP关节角度可自主伸展至180。。结论：ORTHO^X微型外固定支架闭合矫正先天性PIP关节屈曲畸形，术式简单，疗效满意。

Objective ：To observe the treatment outcome of the use of ORTHOFIX mini - external fixator for congenital finger PIP joints flexion deformity. Methods： From June 2009 to July 2011, ORTHOFIX mini - external fixator was closed treated with PIP flexion deformity congenital in 6 cases, including 2 cases in the ring finger of left hand and 4 cases in the little finger of right hand . All cases were type II. Preoperative PIP flexion contraeture angle were from 71.5°to 92.5 °, an average of 85.7 ° ± 1.3 °. ORTHOFIX mini - external fixator was treated with congenital finger PIP joints flexion deformity. All cases were assessed with the American Society of Hand Surgery recommended TAM （total active movement, TAM）. Results：This group of 6 patients with 6 fingers, after a 2.5 - 4 weeks （ average 3 weeks） , the angle of finger PIP could be straightened from to 160.2 ° to 179.5°, an average of 176.7° ± 0. 8°. Average correction angle were 91.0 ° ± 1.3°. After one month operation, According to TAM system evaluation treatment effect, 5 cases were excellent, 1 was good. Six cases were follow - up for 0.5 to 2 year. The PIP joint angle was only up to 160° in 1 case and the angle in the remaining were up to 180°. Conclusions：The method of closed external fixation for finger PIP flexion deformity congenital were simple and the results were satisfactory.