改良石黑法治疗新鲜骨性锤状指

Application of modified Ishiguro method in the treatment of fresh bony mallet finger

目的探讨改良石黑法治疗新鲜骨性锤状指畸形的临床疗效。方法自2018年1月至2020年7月我院共收治23例新鲜骨性锤状指患者。手术均采用改良石黑法(调整阻挡针方向并增加1枚克氏针对骨块进行加压)治疗。统计术后并发症发生情况、骨折愈合时间并采用手指关节总活动度(total active motion,TAM)系统评定法来评价患指功能恢复情况。结果所有患者均闭合复位成功,无针道感染、甲床畸形、皮肤坏死、骨不连、骨折畸形愈合等并发症发生。患者均获得随访,时间为6~26个月,平均9.4个月。骨折愈合时间(6.3±0.1)周,末次随访根据手指关节TAM系统评定法评定患指关节功能均为优。结论改良石黑法治疗新鲜Ⅰb型、Ⅱb型骨性锤状指具有手术操作简单、微创、疗效确切等优点,适合临床推广。

Objective To investigate the clinical efficacy of modified Ishiguro method in the treatment of fresh bony mallet finger.Methods From January 2018 to July 2020,23 patients with fresh bony mallet fingers were treated in our hospital.All the operations were performed with modified Ishiguro method(adjusting the direction of the blocking Kirschner wire and adding another Kirschner wire to pressurize the bone block).The postoperative complications and fracture healing time were counted,and the total range of motion(TAM)system was used to evaluate the recovery of finger function.Results The close reduction was successful in all the patients,and there were no complications such as needle tract infection,nail bed deformity,skin necrosis,bone nonunion and fracture malunion.All the patients were follow-up for 6 to 26 months,with an average of 9.4 months.The fracture healing time was(6.3±0.1)weeks.At the last follow-up,the function of the affected finger joint was evaluated as excellent according to the TAM system.Conclusion The modified Ishiguro method in the treatment of fresh type Ⅰb and Ⅱ b bony mallet fingers has the advantages of simple operation,minimally invasive and definite clinical efficacy,which is suitable for clinical promotion.