微型锚钉重建治疗开放性中央腱止点撕脱

Application of mini anchor in the reconstruction of open central tendon insertion avulsion

目的报告微型骨锚治疗中央腱止点撕脱的临床疗效。方法自2013年10月至2016年8月，对9例9指伸肌腱中央腱止点开放性损伤的患者，彻底清创后先用克氏针将近指间关节固定于伸直位，然后将微型骨锚植入中节指骨基底背侧中央腱附着处，再用锚钉尾部的4-0 DurabraidTM缝合线与撕脱的指伸肌腱中央腱缝合，重建中央腱止点。结果术后随访3～15个月，平均9个月，术区无皮肤坏死，无钮孔畸形，无线结反应，术后X线片未见锚钉松动、脱落。采用Caroli功能评定法评定：优6例，良3例。结论微型骨锚重建中央腱止点，操作简便，易掌握，选择合适的适应证可以取得满意的疗效。

Objective To report the clinical effects of mini anchor in the treatment of central tendon insertion avulsion. Methods From October 2013 to August 2016, 9 cases （9 fingers） of open extensor tendon central tendon injuries were treated. After thorough debridement, the proximal interphalangeal joint was fixed by Kirsclmer wire in extension position, and then mini anchor was drilled into the central tendon insertion site at dorsal base of middle phalanx. The central tendon insertion site was reconstructed by suturing 4-0 DurabraidTM suture at the end of the anchor with avulsed extensor tendon central tendon. Results All the patients were follow-up for 3 to 15 months with an average of 9 months. There was no skin necrosis, no Boutonniere deformity and no suture reaction. No loosening or shedding of anchor was seen from postoperative X-ray film. According to the Caroli function evaluation criteria, the results were excellent in 6 cases and good in 3 cases. Conclusion The reconstruction of central tendon insertion using mini anchor is easy to perform and master, and satisfactory results can be achieved by selecting suitable indications.