Thompson法在伴肌腱缺损的陈旧性锤状指中的应用

Thompson procedure for chronic mallet finger with tendon defect

目的探讨Thompson法治疗伴肌腱缺损的陈旧性锤状指的效果。方法回顾性分析2014年7月至2016年10月华中科技大学同济医学院附属普爱医院手外科收治的9例伸肌腱缺损的陈旧性锤状指患者资料。男4例,女5例;年龄25~56岁,平均36岁。左侧3例,右侧6例;其中示指2例,中指3例,环指3例,小指1例。术后测量远、近侧指间关节活动范围,并观察记录手术并发症。末次随访时采用Dargan功能评定法评定疗效。结果9例患者术后获5~36个月(平均16.5个月)随访。伤口均一期愈合,无感染、皮肤穿破、指端感觉异常或指甲畸形等并发症。所有患者锤状指畸形均获矫正,1例患者术后10周左右再次出现轻度锤状指畸形,并在积极固定8周后完全矫正。末次随访时经Dargan功能评定法评定疗效:优8例,良1例。结论Thompson法治疗伴肌腱缺损的锤状指疗效满意,并发症发生率低。

Objective To evaluate the Thompson procedure in the treatment of chronic mallet finger with tendon defect. Methods From July 2014 to October 2016,9 cases of chronic mallet finger with tendon defect were treated by Thompson procedure at Department of Hand Surgery,Wuhan Puai Hospital.They were 4 males and 5 females,aged from 25 to 56 years (average,36 years).Their disorder was on the left side in 3 cases and on the right side in 6 ones,involving 2 index fingers,3 middle fingers,3 ring fingers and one little finger.The ranges of motion (ROM) for distal and proximal interphalangeal joints were measured after operation.Operative complications were observed and recorded.Dargan functional assessment was used to evaluate the out-comes at the final follow-up. Results All the 9 patients were followed up for 5 to 36 months (average,16.5 months).The wounds healed primarily without such complications as infection,skin breakage,abnormal fingertip sensation or nail deformity.All cases of mallet finger malformation were corrected.About 10 weeks after operation,one case presented with mild mallet finger malformation which was completely corrected after active fixation for 8 weeks.The Dargan assessment at the final follow-up showed 8 excellent and one good cases. Conclusion Thompson procedure can lead to satisfactory outcomes and limited complications in the treatment of chronic mallet finger with tendon defect.