双套圈法与带线锚钉法治疗急性拇指Stener损伤的疗效比较

Comparative study of double-ring cross suture method and suture bone anchor method in the treatment of acute Stener injury of the thumb

目的比较双套圈法和带线锚钉法治疗急性拇指Stener损伤临床疗效。方法回顾性队列研究。纳入2019年1月-2021年7月唐山市第二医院急性拇指Stener损伤患者16例,其中男12例、女4例,年龄19~61(41.0±13.9)岁。16例患者按尺侧副韧带修复方法不同分为2组:采用双套圈法修复的9例纳入双套圈组,采用带线锚钉法修复的7例纳入带线锚钉组。观察指标:(1)比较2组患者年龄、性别、受伤至手术时间等基线资料;(2)比较2组患者手术时间和住院费用;(3)术后8个月按Saetta等评定标准评价患指功能,采用密歇根州手功能调查表(MHQ)评估患者对患指外观的满意度,应用视觉模拟评分法(VAS)评估患指的疼痛程度。比较2组患者上述指标。结果(1)2组患者性别、年龄、受伤至手术时间等基线资料比较,差异均无统计学意义(P值均>0.05)。(2)双套圈组手术时间为(59.3±5.2)min,带线锚钉组手术时间为(60.9±6.2)min,2组间比较差异无统计学意义(t=0.53,P=0.602)。双套圈组住院费用(1.16±0.13)万元,少于带线锚钉组的(1.69±0.08)万元,差异有统计学意义(t=9.44,P<0.001)。(3)16例患者均获随访,随访时间8~24(13.2±5.4)个月。术后8个月,患指功能评定,双套圈组优6例、良2例、可1例,带线锚钉组优5例、良1例、可1例;MHQ评估患指外观的满意度,双套圈组7例非常满意、1例满意、1例一般,带线锚钉组6例非常满意、1例满意;患指疼痛VAS评分,双套圈组无疼痛7例、轻度疼痛2例,带线锚钉组无疼痛5例、轻度疼痛2例:差异均无统计学意义(P值均>0.05)。结论对于急性拇指Stener损伤的治疗,双套圈法与带线锚钉法均可获得较可靠的疗效,且双套圈法住院费用少于带线锚钉法。临床上可以综合考虑术者的操作习惯、患者的经济情况,选择合适的治疗方法。

Objective This study aimed to compare the clinical efficacy of double-ring cross suture method and suture bone anchor method in the treatment of acute Stener injury of the thumb.Methods A retrospective cohort study was conducted.A total of 16 patients with acute Stener injury of the thumb in the Second Hospital of Tangshan from January 2019 to July 2021 were included in this study,including 12 males and four females,aged 19-61(41.0±13.9)years.Sixteen patients were divided into two groups in accordance with different surgical methods.Among them,nine patients were in the double collar group for repairing the ulnar collateral ligament by the double collar method,and seven patients were in the wire anchor group for repairing the ulnar collateral ligament by the wire anchor method.The observational indicators were as follows:(1)The baseline data of patients'age,sex,and time from injury to operation were compared between the two groups;(2)the operation time and hospitalization expenses were compared between the two groups;(3)eight months after operation,the function of the affected finger was evaluated in accordance with Saetta and other evaluation criteria,the Michigan hand function questionnaire(MHQ)was used to evaluate patients'satisfaction with the appearance of the affected finger,and the 10 cm-linear visual analog scale(VAS)was used to evaluate the pain degree of the affected finger.The above indices were compared between the two groups.Results(1)No significant difference was found in terms of gender,age,time from injury to operation,and other baseline data between the two groups(all P values>0.05).(2)The operation time was(59.3±5.2)min in the double collar group and(60.9±6.2)min in wire anchor group,and there was no significant difference between the two groups(t=0.53,P=0.602).Hospitalization expenses of double collar group([11.6±1.3]thousand yuan)were less than those of the wire anchor group([16.9±0.8]thousand yuan),and the difference was statistically significant(t=9.44,P<0.001).(3)All the 16 patients were followed up for 8-24(13.2±5.4)months.Eight months after surgery,the function evaluation of the affected finger showed that in the double collar group,six cases were excellent,two cases were good,and one case was fair.In the wire anchor group,five cases were excellent,one case was good,and one case was fair.MHQ was used to evaluate the satisfaction of the patient's finger appearance.Seven cases in the double collar group were very satisfied,one case was satisfied,and one case was average.Meanwhile,six cases in the wire anchor group were very satisfied,and one case was satisfied.For the pain VAS score of the affected finger,seven cases in the double collar group had no pain,and two cases had mild pain.Meanwhile,five cases in the wire anchor group had no pain,and two cases had mild pain,without statistical significance(all P values>0.05).Conclusion For the treatment of acute thumb Stener injury,the double-ring cross suture method and the suture bone anchor method have relatively reliable efficacy.The hospitalization cost of the double-ring cross suture method is less than that of the suture bone anchor method.Clinically,the operational habits of the operator and the economic situation of patients could be comprehensively considered when choosing the appropriate treatment method.