应用微型钩钢板治疗骨性锤状指的临床研究

Clinical study on the application of mini hook plate in the treatment of mallet finger with avulsion fracture

目的 探讨微型钩钢板治疗骨性锤状指的临床疗效.方法 2012年4月至2013年11月对8例伴有末节指骨基底撕脱骨折的锤状指患者,采用远指间关节（DIP）背侧“S”形或“L”形切口暴露骨折端,直视下复位骨折块后用微型钩钢板固定骨折,纠正锤状指畸形.结果 术后8例全部获得随访,时间为5-24个月,骨折愈合时间为4-7周,平均5.6周.患指DIP主动背伸时欠伸0°- 15°,平均5.0°;主动屈曲丧失0°- 12°,平均2.1°.1例指甲出现轻微隆起脊,无疼痛、关节炎、感染及内固定失效等并发症.术后DIP按Crawford功能评定方法评定：优4例,良3例,可1例.结论 微型钩钢板治疗伴有撕脱骨折的锤状指能达到坚强固定,术后DIP功能恢复满意,疗效可靠.

Objective To evaluate the clinical outcomes of using mini hook plate in the treatment of bony mallet fingers.Methods Eight cases of mallet fingers with avulsion fracture of the distal phalanx base treated between April 2012 and November 2013 were involved in the study.A dorsal S or L shaped incision was made at the distal interphalangeal （DIP） joint to expose the fracture site.Under direct visualization the fracture was reduced and fixed with mini hook plate to correct the mallet finger deformity.Results All the 8 cases were follow-up for 5 to 24 months.Time of fracture healing was 4 to 7 weeks,average healing time being 5.6 weeks.Extension lag of the DIP joints was 5° （range,0° to 15°）.The mean flexion loss of the DIP joints was 2.1° （range,0° to 12°）.Raised ridge of the nail was seen in one case.There were no pain,arthritis,infection,internal fixation failure and other comphcations.Based on Crawford＇s evaluation criteria of the DIP joints,the results were excellent in 4 cases,good in 3 cases and fair in 1 case.Conclusion Application of mini hook plate in the treatment of mallet finger with avulsion fracture can achieve strong fixation and lead to satisfactory postoperative DIP joint function recovery and rehable results.