带线骨锚钉联合克氏针急诊修复指伸肌腱止点断裂20例

Emergency surgical operation repairment of extensor tendon insertion rupture by using suture anchor combined with kirschner wire

目的 评价带线骨锚钉联合克氏针急诊修复闭合性指伸肌腱止点断裂的疗效.方法 对2013年8月-2015年12月收治的20例闭合性指伸肌腱止点断裂患者急诊采用切开、带线骨锚钉修复指伸肌腱,0.8~1.0 mm克氏针固定远指间关节伸直位.术后4周拔除克氏针,逐渐加强远指间关节功能锻炼.结果 术后20例伤口均Ⅰ期愈合,无感染和皮肤坏死发生.所有病例均获得随访,随访时间为2~12个月,平均7.6个月,无1例发生指伸肌腱再断裂.拍X线片复查,未发现锚钉脱出、松动、断裂等.按Dargan功能评定法评价治疗效果,优16例,良3例,可1例,优良率为85%.结论 带线骨锚钉联合克氏针急诊修复指伸肌腱止点断裂固定效果好,手术时间短,术后恢复快,疗效肯定,是治疗指伸肌腱止点断裂的好方法.

Objective To evaluate the effect of emergency surgical operation on repairing the closed extensor tendon insertion rupture with suture anchor and Kirschner wire. Methods 20 patients with closed extensor insertion rupture were treated with incision and suture anchor to repair extensor tendon, distal interphalangeal joint was fixed at extension position. By 0.8~1.0 mm Kirschner wire pulled out the Kirschner wire 4 weeks after surgery, and gradually strengthen the distal interphalangeal joint functional exercise. Results 20 patients＇ incision healed, without infection and skin necrosis. All cases were followed up for 2 to 12 months with an average of 7.6 months, and none of the cases had extensor tendon repture. X-ray review of showed no anchor was prolapesd, loose or broken. According to Dargan function evaluation method, excellent in 16 cases, good in 3 cases, fair in 1 case, with 85% excellent and good rate. Conclusion Suture anchor combined with Kirschner wire has the advantages of good fixation effect, short operation time, quick postoperative recovery and affirmative effect, is a good method to treat the extensor tendon insertion rupture.