纽扣钢板治疗腱性锤状指的临床疗效

Clinical outcomes of button plate used for repairing tendinous mallet finger

[目的]比较纽扣钢板止点重建术与传统拉出缝合术治疗腱性锤状指的临床效果。[方法] 2013年1月—2019年12月,手术治疗腱性锤状指51例患者。其中,26例采用微型纽扣钢板伸肌腱止点重建术(纽扣组),25例采用传统拉出缝合术(缝合组)。比较两组临床效果。[结果]所有患者均顺利完成手术,两组手术时间、术中出血量、术后住院时间的比较差异无统计学意义(P>0.05)。随访时间8~32个月,平均(20.55±6.14)个月。末次随访时,纽扣组远侧指间关节活动度显著优于缝合组(P<0.05)。根据Crawford评定标准:纽扣组优22例、良3例,优良率96.15%;缝合组优8例,良10例,优良率72.00%;两组比较差异具有统计学意义(P<0.05)。纽扣组1例出现背伸受限;缝合组7例出现背伸受限。[结论]微型纽扣钢板伸肌腱止点重建治疗腱性锤状指,肌腱断端缝合牢靠,利于患指早期功能锻炼,临床疗效满意。

[Objective] To compare the clinical outcomes of reattachment of extensor tendon with button plate versus conventional suture in the treatment of tendinous mallet fingers. [Method] From January 2013 to December 2019, 51 patients received surgical treatment for tendinous mallet fingers. Of them, 26 patients underwent reattachment of extensor tendon with button plate(button group), while the remaining 25 patients received conventional pull-out suture of the tendon(suture group). The clinical outcomes were compare between the two groups. [Results] All patients had operation completed successfully with no significant differences between the two groups in operation time, intraoperative blood loss, and postoperative hospital stay(P>0.05). The follow-up lasted for 8 to 32 months, with an average of(20.55±6.14) months. At the latest follow-up, the range of motion of the distal interphalangeal joint in the button group was significantly better than that in the suture group(P<0.05). According to Crawford’s assessment criteria, the clinical outcomes were graded as excellent in 22 cases and good in 3 cases with an excellent and good rate of 96.2% in the button group, whereas excellent in 8 cases and good in 10 cases with an excellent and good rate of 72.0% in the suture group;which was statistically significant between the two groups(P<0.05). The limited extension was noted in a patient of the button group only, whereas 7 patients in the suture group. [Conclusion] This reattachment of extensor tendon with button plate does achieve firm tendon repairing, which is beneficial to the early functional exercise of the affected finger, to ensure the satisfactory consequence.