克氏针加压内固定技术治疗外伤后骨性锤状指的临床研究

Clinical studies on treatment of bony mallet finger with Kirschner wire pressure internal fixation technique

目的探讨克氏针加压内固定技术治疗外伤后骨性锤状指的临床疗效。方法选取2015年1月—2017年1月收治的21例外伤性骨性锤状指患者,采用一枚克氏针加压内固定撕脱的骨折块,另一枚克氏针固定远节指间关节。撕脱骨块均大于末节指骨基底关节面的1/3。结果 21例患者均为Ⅰ期愈合均获得随访,时间6～18个月,平均12个月。骨折块平均在6周左右愈合,术后均未出现骨折块移位、再次骨折、皮肤坏死及针道感染、指甲畸形等。采用Crawford标准效果评估,优18例,良2例,可1例,差0例,优良率为95.2%。结论克氏针加压内固定技术治疗外伤后骨性锤状指,可恢复患指伸肌腱止点与末节指骨的连续性,纠正末节指间关节屈曲畸形、较早功能活动。

Objective This article was to explore the clinical curative effect of Kirschner wire pressure internal fixation technique in the treatment of bony mallet finger. Methods The study enrolled 21 cases of patients suffered from traumatic mallet fractures,and the patients ever got treatment during Jan. 2015 and Jan.2017. A kirschner wire was used to fix the avulsion fracture,and another kirschner wire was used to fix the distal interphalangeal joint. The avulsion fracture was greater than 1/3 of the basal articularis facies.Results All of the 21 patients obtained stage I healing. All patients were followed up for 6 to 18 months,with an average of 12 months. The fracture healed within 6 weeks on average. There was no gression of fracture mass,refracture,skin necrosis,needle track infection,nail malformation occurred. The result of efficacy evaluating by Crawford standard indicated that 18 cases obtained excellent efficacy,2 cases were good,and 1 case was ordinary. The excellent and good rate was 95. 2%. Conclusions This technique could restore the continuity between the stop point of extensor tendon and the distal interphalangeal joint,correct flexion deformity of the distal interphalangeal joint,promote early functional activity.