改良抽出钢丝法治疗指伸肌腱止点损伤

Modified pullout wire technique for extensor tendon insertion injuries

目的探讨改良抽出钢丝法治疗指伸肌腱止点损伤的方法，以减少并发症。方法2006年5月至2012年6月，采用改良抽出钢丝法治疗指伸肌腱止点损伤46例47指，克氏针纵形穿末节指骨而不穿过远指间关节，尾端折成“z”形弯钩；钢丝于伸肌腱止点以近0．8～1．0cm处如同Kessler缝合法穿过，两端经末节指骨基底两侧系于克氏针弯钩处拧紧。结果术后随访8～33个月，手指远指间关节活动度在50~一7俨，无并发症。按Dargan功能评定法评定：优42例43指，良4例4指；优良率为100％。结论改良抽出钢丝法治疗伸肌腱止点损伤，方法简单、廉价而并发症少，治疗效果满意。

Objective To explore the modified pullout wire technique for treatment extensor tendon insertion injuries and discuss ways to decrease complications. Methods From May 2006 to June 2012, 46 eases 47 fingers of extensor tendon insertion injuries were treated with modified pullout wire technique. A Kirschner wire （K-wire） was longitudinally inserted into the distal phalanx without going through the DIP joint. The end of the K-wire was bent to form a ＂Z＂ shaped hook. A stainless steel wire was threaded through the extensor tendon about 8 to 10 mm to the insertion in a Kessler suture fashion and then went through the phalanx base on both sides to be fastened on the K-wire hook. Results All eases were follow-up for 8 to 33 months postoperatively. DIP joint range of motion was between 50° and 70°. No complications were observed. According to Dargan scales, the result was excellent in 42 eases 43 lingers and good in 4 eases 4 fingers, with the exeellent and good rate being 100%. Conclusion The modified pullout wire technique leads to satisfactory results and should be a predictable, low-morbidity, low-cost treatment, safe and simple method for treatment of extensor tendon insertion injuries.