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Clinical effect comparison of three different operative methods for treatment of chronic Doyle typeⅠa mallet finger |
QI Baochuang XU Xianchun QIU Yu JIA Lin |
the First Department of Orthopaedics, the First People′s Hospital of Yibin, Sichuan Province, Yibin 644000, China |
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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.
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[1] 于志亮,高顺红,张净宇,等.克氏针双夹扣法固定治疗伴骨质缺损的陈旧性骨性锤状指[J].中华创伤杂志,2016,32(8):714-716.
[2] 刘欢,李崇杰,梁晓旭,等.锤状指手术治疗方法的探讨[J].实用手外科杂志,2018,32(3):300-301.
[3] 史占雷,李辉,于涛,等.改进克氏针固定角度治疗新鲜闭合锤状指[J].基层医学论坛,2019,23(1):143-144.
[4] 王玉龙.康复功能评定学[M].北京:人民卫生出版社,2012:358-359.
[5] 何斌,张超.体外冲击波治疗恢复期手指屈肌腱损伤患者的临床效果观察[J].中国康复,2016,31(6):455-456.
[6] 陈少贞,张涛,朱庆棠,等.两种不同外固定方式对新鲜锤状指临床疗效的单盲随机对照研究[J].中国康复医学杂志,2012,27(11):1006-1010.
[7] Wolfe SW.格林手外科手术学[M].6版.北京:人民军医出版社,2012:155-156.
[8] 宗宝宪,朱纲领,邢向卫.陈旧性锤状指的手术治疗[J].实用手外科杂志,2015,(4):437-438.
[9] De Spirito D,Giunchi D. The Pull-out K-wire Anchorage:The "Shepherd′s Crook" Technique [J]. Tech Hand Up Extrem Surg,2017,21(3):85-90.
[10] 郑力峰,谢昀,叶君健,等.骨锚钉结合克氏针与单纯克氏针治疗锤状指的比较研究[J].中华手外科杂志,2018, 34(5):329-332.
[11] 顾松,谢仁国.单纯克氏针与微型骨锚钉联合克氏针治疗DoyleⅠa型锤状指的疗效对比[J].中华手外科杂志,2018,34(5):367-369.
[12] 贾杰,魏智辉,陈伟,等.经骨隧道线扣技术腱骨缝合治疗腱性锤状指[J].中华手外科杂志,2018,34(5):336-337.
[13] 孙文弢,张文龙,张净宇,等.锤状指治疗中固定指位的应用解剖研究[J].中华解剖与临床杂志,2017,22(1):33-36.
[14] 李红明,高原.自体肌腱与异体肌腱重建前交叉韧带疗效对比Meta分析[J].医学综述,2017,23(24):4976-4982.
[15] 柴国忠,范海珍,陈戬宏,等.自体或同种异体肌腱重建喙锁韧带联合锁骨钩钢板治疗肩锁关节脱位疗效分析[J].中国医学装备,2017,14(12):68-71.
[16] 刘松浪,蒋煜青,梁传兴,等.膝关节镜下前交叉韧带重建的疗效影响因素分析[J].中国医学创新,2018,15(13):118-120.
[17] Apard T,Candelier G. Wide-awake ultrasound-guided percutaneous extensor central slip tenotomy for chronic mallet finger:A prospective study of 14 cases(with videos) [J]. Hand Surg Rehabil,2017,36(2):86-89.
[18] 赵志明,邢丹谋,任东,等.Thompson法治疗伴鹅颈畸形的陈旧性锤状指[J].中华手外科杂志,2017,33(2):81-83.
[19] 牛晓锋,肖良宝,曾海燕,等.可吸收微型骨锚在腱性锤状指损伤治疗中的重建作用[J].实用手外科杂志,2015(3):244-246.
[20] 施海峰,芮永军,吴柯,等.陈旧性锤状指的手术治疗[J].中华手外科杂志,2017,33(4):264-265. |
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