改良缝合法结合克氏针内固定治疗锤状指的疗效分析

Clinical efficacy of modified pull-out suture technique in the treatment of mallet fingers

目的探讨改良缝合法治疗锤状指的临床疗效。方法对我院2010年6月~2011年7月间收治的23例锤状指患者采用Bunnell双针缝线缝合伸肌腱后,打结固定于指腹的改良缝合法结合克氏针固定的手术方法治疗。术后不用外固定,6w后拔除克氏针开始功能锻炼。结果 1例术后2m因线结反应发生切口感染,锤状指畸形复发;其余患者切口均Ⅰ期愈合。23例患者均获随访,随访时间12~24m。末次随访时,采用Crawford功能评定标准：优12例,良9例,可1例,差1例,优良率91.3%。结论改良缝合法是治疗锤状指简便、有效方法。

Objective To evaluate the clinical efficacy of modified pull-out suture technique in the treatment of mallet fingers.Methods From June 2010 to July 2011,23 patients with mallet fingers were treated in our hospital.All the patients were treated by modified pull-out suture methods in which the broken tendons were sutured with double metal needle Bunnell＇s suture and a knot is tied palmarly,then a 1.0 mm K-wire was inserted longitudinally from the tip of the finger into the middle phalanx to hold the DIPJ in slight.No external fixation was used postoperatively.The Kirschner wire was removed 6 weeks after operation,then functional exercises were performed.Results 1 patients had delayed wound infection because of silk line reaction 2 months after operation,and recurred mallet finger deformity.All the other patients obtained healing by first intention.All patients were followed up for 12~24 months（17.3 months in average）.At the final followup,according to the Crawford functional assessment system,12 cases were excellent,9 good,1 fair and 1 poor,with the choiceness rate of 91.3%.Conclusion Modified pull-out suture technique is smiple and effective in the treatment of mallet finger.