Abstract：Objective To compare the clinical effect among reconstruction of tendon insertion, skin tightening suture and distal interphalangeal joint fusion in the treatment of chronic Doyle typeⅠa mallet fingers. Methods A retrospective analysis was conducted on the clinical data of 81 patients with chronic Doyle typeⅠa mallet fingers treated in the First Department of Orthopaedics of the First People′s Hospital of Yibin in Sichuan Province from May 2007 to February 2017. The patients were divided into reconstruction group (40 cases), tightening suture group (27 cases) and fusion group (14 cases) base on the treatment method selected by the patients. They were followed up for 12 months. The basic conditions, general conditions of surgery and hospitalization, Dargan function evaluation of the affected fingers, Carroll scoring of hand functions, the visual analog scale (VAS) and subjective satisfaction evaluation of patients were compared among the three groups. Results The duration of operation, and the hospitalization cost of tightening suture group were lower than those of the reconstruction group and the fusion group, and the differences were statistically significant (P ＜ 0.05). There were no significant differences in the hospitalization time and the total incidence of complications among the three groups (P ＞ 0.05). Twelve months after operation, the excellent and good rate of Dargan function evaluation in the fusion group was significantly lower than that in the reconstruction group and the tightening suture group, and the difference was statistically significant（P ＜ 0.05）. There were no significant differences in Carroll scores, VAS scores and the excellent and good rate of patients′ satisfaction among the three groups (P ＞ 0.05). Conclusion All the three surgical methods are available to achieve high patient satisfaction and good hand functions, and can be used for the treatment of chronic mallet fingers. However, reasonable selection should be made according to the condition and patients′ requirements for treatment.
2019, Vol. 16 
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