克氏针张力牵引法治疗腱性锤状指畸形

Kirschner wire tension traction for the treatment of tendinous mallet finger deformity

目的探讨克氏针张力牵引法治疗腱性锤状指畸形的临床疗效。方法自2012年6月至2014年8月，我们对27例腱性锤状指患者应用克氏针张力牵引法治疗，术后夹板保护克氏针尾端，近指间关节及掌指关节正常活动，6周后拆除牵引线、拔除克氏针。结果术后2例失访，25例获得随访，随访时间为9—16个月，平均13个月。按Crawford锤状指疗效评价体系评估：优7例，良15例，可3例，优良率为88％。结论采用克氏针张力牵引法固定伸肌腱，手术操作简单，可明显纠正锤状指畸形，获得良好的关节活动度，是治疗锤状指畸形较为有效的方法。

Objective To explore the clinical outcomes of treating tendinous mallet finger deformity with Kirschner wire tension traction. Methods From June 2012 to August 2014, 27 patients （27 fingers） with a tendinous mallet finger deformity were treated with Kirschner wire tension traction. Postoperatively a small splint was applied only to protect the extruding K-wires and allowed free movement of the proximal interphalangeal joint and metacarpophalangeal joint. At 6 weeks postoperatively, the K-wires and traction sutures were removed. Active and passive distal interphalangeal joint exercises were initiated immediately afterwards. Results Two patients were lost for follow-up. The rest 25 patients were follow-up for 9 to 16 months postoperatively, with an average of 13 months. According to Crawford＇s evaluation criteria, the results were excellent in 7 cases, good in 15 cases and fair in 3 cases. The overall good-excellent rate was 88%. Conclusion Kirschner wire tension traction is an effective treatment for tendinous mallet finger. The procedure is simple yet corrects the deformity and results in satisfactory joint motion.