指间关节侧副韧带损伤的临床诊治

Diagnosis and treatment of interphalangeal lateral collateral ligament injury

目的分析与探讨指间关节侧副韧带损伤的临床诊治。方法 2010年1月至2015年1月采用不同手术疗法治疗各种类型手部指间关节侧副韧带损伤28例。术后铝板、石膏或支具将患指伸直位固定,4~6周去除外固定及钢丝,逐渐、循序渐进地进行功能锻炼直至恢复正常。疗效评定:疼痛程度采取VAS评分法、功能评定采用Dargan功能评定法进行评定。结果伤口一期愈合率为100%。随访3~12个月,指骨基底部撕脱性骨折对位良好,均达骨性愈合,无手指畸形发生。疗效评定:疼痛程度采取VAS评分法评定:术前(5.86±1.21)分,术后(2.50±1.07)分,差异有统计学意义(P<0.05)。功能评定采用Dargan功能评定法进行评定:指间关节活动度术前(47.86±7.20),术后(80.00±7.11),差异有统计学意义(P<0.05)。优良率89.29%。结论手术修复关节囊及重建侧副韧带是理想的治疗方法,术后辅以积极的康复治疗,可有效地恢复手指功能,避免伤残。

Objective To investigate the diagnosis and treatment of interphalangeal lateral collateral ligament injury.Methods Twenty-eight patients with interphalangeal lateral collateral ligament injury who were treated in our hospital from January 2010 to January 2015 were enrolled in the study. These patients were treated by different surgical methods,with using aluminium panels or gypsum to fix injuried finger straightly,to remove the external fixation during 4 ~ 6 weeks after operation and to carry out functional exercise gradually until returning to normal. The therapeutic effects were observed,moreover the pain degree of patients was assessed by VAS score and functional assessment was performed according to Dargan functional scoring. Results The primary wound healing rate was 100%. After 3 ~ 12 month follow up,the para position of avulsion fracture of phalanx base was good,with bone union rate being 100%,without finger deformity. The VAS scores before operation were（ 5. 86 ± 1. 21） points,which were（ 2. 50 ± 1. 07） points after operation,there were significant differences（ P〈0. 05）.The Dargan scores of interphalangeal joint range of motion before operation were（ 47. 86 ± 7. 20） points,however,which were（ 80. 00 ± 7. 11） points after operation,there were significant differences（ P〈0. 05）,with excellent and good rate being89. 29%. Conclusion It is an ideal therapeutic method to carry out surgery to restore joint capsule and reconstruct collateral ligaments in treatment of interphalangeal lateral collateral ligament injury,moreover, postoperative active rehabilitation treatment can effectively restore finger function and prevent disability.