Thompson法治疗伴鹅颈畸形的陈旧性锤状指

The Thompson procedure for treating chronic mallet finger with swan neck deformity

目的评估Thompson法治疗伴鹅颈畸形的陈旧性锤状指的治疗效果。方法自2013年6月至2014年10月，我们采用Thompson法治疗8例伴有鹅颈畸形的陈旧性锤状指患者，术前术后测量远指间关节和近指间关节活动范围，采用Abouna和Brown标准进行治疗效果评价。结果术后8例患者均获得随访，时间为4～22个月，平均12．5个月。末次随访时远指间关节平均伸展-6°（-10°～-5°），屈曲61°（45°～85°）；近指间关节平均伸展-40（-30°～0°），屈曲90°（80°～110°）。所有患者鹅颈畸形均矫正，1例术后出现轻度纽孔畸形，并在移植腱近端打结处形成浅凹的瘢痕。根据Ahouna和Brown标准评估：7例治愈，1例改善。结论Thompson法手术给伴鹅颈畸形的陈旧性锤状指患者提供了一种可行的矫正方法。

Objective To evaluate the outcomes of treating chronic mallet finger with swan neck deformity with Thompson procedure. Methods Eight cases of chronic mallet finger with swan neck deformity were treated with the Thompson procedure from June 2013 to October 2014. Ranges of motion of the distal interphalangeal （DIP） and proximal interphalangeal （PIP） joints were measured both pre- and postoperatively. The treatment outcomes were evaluated using Abouna and Brown criteria. Results All the patients were follow-up for 4 to 22 months with an average of 12.5 months. At the final follow-up the average extension lag of the DIP joint was -6° （range, -10°to -5°）, while that of the PIP joint was -4° （range, -30° to 0 °）. Flexion was 61° （range, 45° to 85°） for the DIP joint and 90a （range, 80° to 110°） for the PIP joint. The swan neck deformity was corrected in all the cases. Mild Boutonniere deformity and a dimple at the proximal tied end of the tendon graft were seen in 1 case. Assessment by Abouna and Brown criteria revealed that 7 of 8 patients were recognized as cured and one as improved. Conclusion The Thompson procedure provides a predictable method for correcting loss of DIP joint extension with PIP joint hyperextension. It is an effective technique for treating chronic mallet finger with a swan neck deformity.