改良第二跖趾关节修复掌指关节背侧缺损的应用解剖

Application of modified second toe joint to repair the dorsal defect of the dorsal part of the dorsal hand

目的探讨改良第二跖趾关节修复掌指关节背侧缺损的应用解剖。方法选取2006年12月到2014年12月收治的掌指关节背侧缺损患者共68例,将患者随机分为两组,每组34例,A组行改良第二跖趾关节修复治疗,B组行拇短伸肌半腱移位修复,对比两组患者随访痊愈率和并发症等现象。结果术后3个月,A组优9例,良24例,差1例,优良率为91.18%;B组优8例,良18例,差8例,优秀率为76.47%;组间比较差异有统计学意义(P<0.05)。A组患者的手术时间、开始活动时间、住院时间明显短于B组(P<0.05),术中出血量明显低于B组(P<0.05),ASIA评分明显高于B组(P<0.05)。结论改良第二跖趾关节修复治疗掌指关节背侧缺损能取得满意的效果,能有效提高痊愈率,缩短患者康复时间,使患者早日恢复活动能力,具有积极的临床推广意义。

Objective To investigate the application of the modified second toe joint to repair the dorsal defect of the dorsal part of the dorsal finger and its effect. Methods Sixty-eight cases with metacarpophalangeal joint dorsal defect from December 2006 to December 2014 were selected and randomly divided into two groups with 34 cases in each group. Group A received the modified second metatarsophalangeal joint repair treatment, and group B received extensor pollicis brevis tendon transposition, Recovery rate and com- plications of the phenomenon over followed up of the two groups of patients were compared. Results After operation of three months, 9 cases exellent, 24 cases good, 1 case bad in group A, and the rate of excellence and good was 91.18% ; 8 cases exellent, 18 cases good, 8 case bad in group B, and the rate of excellence and good was 76. 47%, and the difference of the two groups was significant（P 〈 0. 05）. The time of surgery, start time, duration of hospital stay in group A were significantly shorter than those in group B （P 〈 0. 05）, intraoperative bleeding was significantly lower than that in group B （P 〈 0. 05）, and the ASIA score was significantly higher than that in group B （P 〈0. 05）. Conclusion The modified second metatarsophalangeal joint repair in the treatment of metacarpophalangeal joint dorsal defect can achieve satisfactory results, effectively improve the cure rate, shorten the recovery time of patients, let patients as soon as possible to restore activity, so it has positive clinical significance.