摘要
目的 探讨改良Kessler缝合联合缝线悬吊固定技术治疗闭合性腱性锤状指的临床疗效.方法 自2018年3月至2021年3月,我们对21例闭合性腱性锤状指患者,采用改良Kessler缝合肌腱止点,牵引线贯穿末节指骨基底骨隧道,并悬吊固定远指间关节克氏针的弯钩进行治疗.术后6周拆除悬吊线、拔出克氏针,分别于术后3、6、9个月进行远指间关节活动度测量及疼痛视觉模拟评分(visual analogue scale,VAS)测定,并采用Crawford锤状指疗效评价体系评估疗效.结果 术后所有患者均获得随访,时间为9～18个月,平均12个月.术后9个月随访时的VAS结果为0～4分,平均0.6分,其中0～2分者共20例;Crawford锤状指疗效评价结果:优14例,良5例,可2例.结论 改良Kessler缝合联合缝线悬吊固定法可明显纠正锤状指畸形,操作简便,功能恢复良好,并发症少,值得推广.
Abstract
Objective To explore the clinical efficacy of modified Kessler suture combined with suture suspension fixation technique in the treatment of closed tendinous mallet finger.Methods From March 2018 to March 2021,21 cases of closed tendinous mallet fingers were treated with modified Kessler suture attendon insertion,traction suture through the bone tunnel of distal phalanges basal,then suspension on the hook of the Kirschner wire which used to fix the distal interphalangeal joint.The suspension suture and Kirschner wire were removed at 6 weeks after the operation.The range of motion of distal interphalangeal and visual analogue scale(VAS)were measured at 3,6 and 9 months after surgery,respectively.And the Crawford mallet finger efficacy evaluation system was used to evaluate the efficacy.Results All patients were follow-up for 9 to 18 months,with an average of 12 months.The VAS score at 9 months after surgery was 0 to 4 points,with an average of 0.6 points,including 20 cases with 0 to 2 points.The results of Crawford mallet finger were excellent in 14 cases,good in 5 cases and fair in 2 cases.Conclusion The modified Kessler suture combined with suture suspension fixation can obviously correct the malformation of the tendinous mallet finger,with simple operation,good functional recovery and few complications.It is worth promoting.
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