一种新的锤状指分型与相应治疗方法的分析

A new clinical classification and the corresponding treatment of Mallet finger

目的分析目前锤状指的各种临床分型，提出不同的分型观点，并根据不同分型采取相应的治疗方法，分析其疗效。方法在以往分型的基础上提出了新的临床分型，并在术前根据不同分型确定相应的治疗措施，从2009年2月一2013年12月，对58例锤状指畸形的病人进行治疗，其中保守治疗20例，成功6例，另14例二期行手术治疗。52例手术病人根据新的临床分型分别采取相应的手术方式，其中微型锚钉固定36例，可抽出钢丝固定4例，单枚螺钉固定3例，直接缝合6例，关节融合3例。结果术后随访4—30个月，按照Patel的疗效评价体系，其中优28例，良21例，中6例，差3例，优良率84．4％，疗效满意。结论根据病史及影像学资料，术前即可确定锤状指的临床分型，并明确手术方式，做好充分的术前准备，临床病例证实新的分型具有可行性，且临床评价满意。

Objective To analyze various clinical parting of mallet finger, put forward different views of parting, and practice corresponding treatment method with their curative effects analyzed. Methods Along with the treatment advances of the mallet finger, we put forward new clinical classification by modification on the past classification, and determines the corresponding treatment measures according to the different classfication. From February 2009 to December 2013, 52 cases with mallet finger deformity were treated. 20 cases received conservative treatment, 6 cases were successful and others need surgical correction. 52 cases were operated according to the new classificaion：36 cases were treated by mini Anchors;4 cases were treated by pullout steel wire with button;3 cases were treated with Single screw;6 cases were treated by direct suture;3 case was treated by fusion of joint. Results The patients were followed from 4 months to 30 months. The results were excellent in 28 patients, better in 21, good in 6, and fair in 3 according with Palel＇ s evaluation standards. Conclusion It can determine clinical classification and operation method of the mallet finger before operation according to the medical history and X-ray, clinical cases confirmed that new cliassification is practical and satisfactory.