骨膜外克氏针固定并切开修复Ⅰ区伸肌腱断裂

Periosteal kirschner fixation and cut repairment to repair extensor tendon rupture in Ⅰarea

目的：探讨骨膜外—滑车内单枚克氏针固定远侧指间关节治疗Ⅰ区伸肌腱断裂的临床疗效。方法2008年3月—2012年12月，对22例锤状指进行手术治疗。采用1.5 mm单枚克氏针徒手骨膜外—滑车内穿入，至手指近节基底部，从而阻挡、限制远侧指间关节的屈曲活动，使远侧指间关节于伸直或稍过伸位，直视下修复伸肌腱。术后6~8周拔除克氏针进行远侧指间关节主、被动屈伸活动。结果术后随访13~38个月（平均16个月），采用Crawford法进行疗效评定：优7例，良13例，可2例，差0例。所有患者均无指甲畸形、指掌侧固有神经损伤及肌腱粘连、腱鞘炎的发生。结论应用单枚克氏针骨膜外固定并切开修复肌腱，具有简化操作程序、固定牢靠，且不损伤远侧指间关节软骨关节面的优点，是治疗锤状指的有效方法。

Objective To discass the clinical effect of single periosteal kirschner fixation and cut repairment to repair extensor tendon rupture in areaⅠ. Methods From March 2008 to December 2012, 22 cases of hammer finger were operated 1.5 mm single kirschner was fixed from periosteam to the basement of proximal phalangeal to inhibit the flation of distal interphalangeal joint and fix the distal interphalangeal joint at extention position repair the tendon under straight. The needle was pulled out after 6~8 weeks, and passive and active rehabilitation was performeal. Results Aftear 13~38 months＆#39; follow up （16 months on average）. The effect was measured by crawford method： excellent 7cases; good 13 cases; fail 2 cases; poor 0 cases. All cases have no nail deformity, digital nerve damage and tendon adhesion or tenosynovitis. Conclusion Sigle periosteal kirschner fixation and cut repairment has the advatages of simple operation procossure stable fixation, and no damage to the articalar surface is an effective method to treat hammer finger.