CAJ | 학술논문

目的探讨有骨片和无骨片的Ⅰ型锤状指手术疗效的差异.方法 2005年至2010年,收治46例Ⅰ型锤状指患者,其中A组22例,为伸肌腱止点处有撕脱骨折,术中采用克氏针固定远指间关节和撕脱骨片;B组24例,为单纯伸肌腱止点处断裂,不伴撕脱骨折,术中采用克氏针固定远指间关节,根据肌腱断裂情况选择缝合方法.两组均在术后5～7周拔除克氏针.结果术后两组随访时间为5～38个月,平均16个月.依据Patel标准评价结果:A组优7例,良5例,中3例,差7例;B组优7例,良3例,中10例,差4例.A组中功能评分为差的比例占31.8％,多于B组差的比例16.7％,但B组中功能仅恢复到中的患者占41.7％.两组优良率的差异无统计学意义(P＞0.05).结论有远节指骨基底部撕脱骨片的锤状指功能差的患者是无撕脱骨片患者的近2倍,无骨片的锤状指功能为中的比例较大(41.7％),但两组疗效基本相同.
목적 탐토유골편화무골편적Ⅰ형추상지수술료효적차이.방법 2005년지2010년,수치46례Ⅰ형추상지환자,기중A조22례,위신기건지점처유시탈골절,술중채용극씨침고정원지간관절화시탈골편;B조24례,위단순신기건지점처단렬,불반시탈골절,술중채용극씨침고정원지간관절,근거기건단렬정황선택봉합방법.량조균재술후5～7주발제극씨침.결과 술후량조수방시간위5～38개월,평균16개월.의거Patel표준평개결과:A조우7례,량5례,중3례,차7례;B조우7례,량3례,중10례,차4례.A조중공능평분위차적비례점31.8％,다우B조차적비례16.7％,단B조중공능부회복도중적환자점41.7％.량조우량솔적차이무통계학의의(P＞0.05).결론 유원절지골기저부시탈골편적추상지공능차적환자시무시탈골편환자적근2배,무골편적추상지공능위중적비례교대(41.7％),단량조료효기본상동.
Objective To analyze the treatent outcomes of type Ⅰ mallet fingers with or without bony fragment.Methods From 2005 to 2010,46 patients with type Ⅰ mallet fingers were treated.They were divided into two groups.In group A,22 patients had type Ⅰ mallet fingers with avulsion fracture at the extensor inserton.The distal interphalangeal joint and the avulsed bone fragment were fixed with K-wires.In group B,24patients had type Ⅰ mallet fingers without a fracture.The distal interphalangeal joint was fixed with a K-wire,and the ruptured tendon was sutured.The K-wire was removed after 5 to 7 weeks in both groups.Results All patients in both groups were follow-up for 5 to 38 months,with an average of 16 months.According to Patel' s evahation standard,there were 7 cases graded as excellent,5 cases as good,3 cases as fair,and 7 cases as poor in group A; there were 7 cases as excellent,3 cases as good,10 cases as fair,and4 cases as poor in group B.The percentage of poor function in group A was 31.8％,higher than the percentage of poor function in group B which was 16.7％.However,fair function in group B accounted for 41.7％.There were no significant differences in excellent rates between two groups ( P ＞ 0.05).Conclusion Poor treatment outcomes in patients of type Ⅰ mallet fingers with distal phalanx base avulsion fracture is almost twice as much as in patients of type Ⅰ mallet fingers without avulsion fracture fragments.Fair functional outcomes in patients without avulsion bone fragments accounted for 41.7 ％.The overall results were similar between the two groups.