改良式伸肌腱止点重建治疗锤状指畸形

Treatment of Mallet Fingers by Reconstruction Insertion of Modified Extensor Tendon

目的：探讨一种指伸肌腱止点重建的改良固定方法。方法：对2012年12月-2013年12月在本院治疗的20例锤状指患者，术中采用直径1.0mm克氏针将远指间关节固定于过伸位10°-15°，远端预留约2cm并向掌侧弯曲成一钩状．用细钢丝横穿伸肌腱止点经指腹抽出固定于折弯的克氏针上，6周后拔除克氏针及钢丝进行远指间关节屈伸功能锻炼。结果：20例用改良后的方法行伸肌腱止点重建，术后没有发生局部组织坏死和肌踺再断裂，术后随访3-6个月，按Dargan功能评定法：优17例，良2例，尚可1例，差0例，优良率95％。结论：改良后的指伸肌腱止点重建技术有效避免了局部组织坏死，重建效果可靠，值得临床推广。

Objective： To explore a modified fixation method of reconstruction of extensor tendon insertion point. Method ： 20 cases of mallet finger patients were treated from December 2012 to December 2013 in our hospital, the distal interphalangeal joint hyperextension position 10-15 degree by I mm diameter Kirschner wire fixation in operation.The distal remoted about 2. cm and to palmar bent into a hook, with a fine wire acrossed the extensor tendon of finger pulpped extract Kirschner wire fixation in heading,Result： 20 cases with modified method by extensor tendon reconstruction, postoperative no localized tissue necrosis and tendon ruptures, patients were followed up for 3-6 months, according to Dargan function evaluation; excellent in 17 cases, goad in 2 cases, acceptable outcome in 1 cases, poor in 0 cases, the excellent and good rate was 95%,Conclusion： The modified extensor tendon reconstruction technique can effectively avoid the local tissue necrosis, reconstruction and reliable effect, it is worth the clinical promotion.