新型手指Ilizarov外固定架治疗指间关节屈曲挛缩畸形10例

New Finger Ilizarov External Fixator for Treatment of 10 Cases of Flexion Contracture Deformity of Finger Joint

目的探讨新型手指Ilizarov外固定架治疗指间关节屈曲挛缩畸形的疗效。方法采用新型手指Ilizarov外固定架治疗手指指间关节屈曲挛缩畸形患者10例,分别在指间关节远近指骨用克氏针交叉固定,配合使用两个半环形支架牵伸,注意避免损伤血管神经。术后逐渐调整牵伸杆,使其产生持续的牵伸力,缓慢矫正指间关节屈曲挛缩畸形,在牵伸矫正过程中,定期复查X线片。观察患者术前及术后功能评分的变化,并随访评价其疗效。结果患者治疗前后近端指间关节Tada评分比较,差异有统计学意义(P<0.01);10例病人中,9例术后牵伸指间关节最终伸屈活动达100°~80°,1例伸屈活动达79°~60°,外形和功能均达到满意效果,且无血管、神经损伤或针道感染等并发症。结论新型手指Ilizarov外固定架能有效矫正近节指间关节屈曲挛缩畸形,改善手指的外形和功能。

Objective To explore the efficacy of new finger Ilizarov external fixator in the treatment of flexion contracture deformity of finger joint.Methods Ten cases of finger joint flexion contracture deformity were treated by new finger Ilizarov external fixator method.The finger joint near and far phalanx with kirschner wire cross were fixed,with the use of two half-ring stent,attention to avoid injury of vascular nerves.The extension rod was adjusted gradually after the operation to produce a continuous stretching force and correct the finger joint flexion contracture deformity.In the process of drafting,the X-ray tablets were regularly reviewed.The preoperative and postoperative functional scores of patients were recorded and its effect by follow-up was evaluated.Results The Tada scores of the proximal interphalangeal joint before and after treatment were statistically significant(P<0.01).All of the 10 patients,9 cases of the postoperative extension of the joint final flexion activity 100°~80°,one case of stretching activity reached 79°~60°,the appearance and function of satisfactory results.There were no complications such as vascular,never injury or needle tract infection after operation.Conclusion The new finger Ilizarov external fixator could effectively correct the flexion contracture deformity of the proximal knuckle,and improve the shape and function of the finger.