肌腱-骨移植重建止点修复疗腱性锤状指的临床应用

Clinical Applied of Tendon-Bone Graft for Tendinous Mallet Fingers

目的探讨肌腱-骨复合组织治疗腱性锤状指的手术技术、临床效果及并发症。方法自2014年1月至2017年6月共有12例锤状指患者接受肌腱-骨复合组织重建止点修复腱性锤状指。术后对患者进行随访评价,观察临床效果及并发症情况。结果12例均获得随访,时间6~30个月,平均16.8个月。切口均为Ⅰ期愈合,所有患者均骨性愈合。临床效果采用TAM系统评定疗效:优9例,良2例,可1例,优良率91.66%。术后并发症:供区疼痛、指甲畸形伴术后10周甲沟炎1例,术后3个月发现线结排异反应1例。结论肌腱-骨复合组织移植物移植是治疗腱性锤状指的有效可靠的手术方法,临床效果满意但需要学习曲线。

Objective To investigate the surgical techniques,clinical effects and complications of tendon-bone graft for Tendinous Mallet Fingers.Methods From January 2014 to June 2017,a total of 12 patients received tendon-bone graft to repair Tendinous Mallet Fingers.Postoperative followup evaluation of patients was performed to observe the clinical effects and complications.Results All 12 cases were followed up for 6-30 months with an average of 16.8 months.All incisions were healed by phaseⅠand all patients had bone healing.The clinical effect was evaluated by TAM system:excellent in 9 cases,good in 2 cases,fair in 1 case,and excellent rate of 91.66%.Postoperative complications:pain in the donor site,nail malformation with one case of paronychia after 10 weeks of operation,and one case of Suture reject reaction at 3 months after operation.Conclusion The transplantation of tendon-bone graft is an effective and reliable surgical method for Tendinous Mallet Fingers.The clinical results are satisfactory but the learning curve is needed.