CAJ | 학술논문

目的探讨一种改良的指伸肌腱止点重建的修复方法.方法对13例新鲜指伸肌腱止点撕脱的患者,采用1.0mm克氏针在手指末节基底垂直钻“T'”形孔,将伸肌腱近断端用3-0肌腱缝线经骨孔固定于末节基底部.6周后拔除克氏针,远指间关节继续使用支具固定于背伸位,8周后白天逐步加强患指伸屈活动,夜间继续支具佩戴至10周.结果术后12例伤口Ⅰ期愈合,1例因指背皮肤损伤严重,术后肌腱外露,采用皮瓣修复后愈合.术后随访4 ～ 30个月,锤状指畸形矫正,患指活动无疼痛.按照中华医学会手外科学会上肢部分功能评定试用标准评定:优11例,良1例,差1例;优良率92.3％.结论在末节指骨基底钻孔,通过改良方法将指伸肌腱止点固定于末节基底重建伸肌腱止点是一种简便可行的手术方法.
목적 탐토일충개량적지신기건지점중건적수복방법.방법 대13례신선지신기건지점시탈적환자,채용1.0mm극씨침재수지말절기저수직찬“T'”형공,장신기건근단단용3-0기건봉선경골공고정우말절기저부.6주후발제극씨침,원지간관절계속사용지구고정우배신위,8주후백천축보가강환지신굴활동,야간계속지구패대지10주.결과 술후12례상구Ⅰ기유합,1례인지배피부손상엄중,술후기건외로,채용피판수복후유합.술후수방4 ～ 30개월,추상지기형교정,환지활동무동통.안조중화의학회수외과학회상지부분공능평정시용표준평정:우11례,량1례,차1례;우량솔92.3％.결론 재말절지골기저찬공,통과개량방법장지신기건지점고정우말절기저중건신기건지점시일충간편가행적수술방법.
Objective To explore a modified procedure for reconstruction of extensor tendon insertion.Methods A total of 13 cases of acute avulsion of the extensor tendon insertion were involved.A 'T ' shaped hole was drilled on the base of the distal phalanx perpendicularly by a 1.0 mm K-wire.3-0 tendon suture woven in the terminal extensor tendon was threaded through the drill holes on the distal phalanx to reattach the tendon insertion.DIP joint was fixed at extension by a K-wire which was removed in 6 weeks.A splint was applied to keep the DIP joint in extension till 8 weeks postoperatively when finger extension-flexion movement resumed.A night splint was used till 10 weeks for added protection.Results Primary wound healing was achieved in 12 cases.Wound dehiscence and extensor tendon exposure were seen in one case with severe dorsal skin damage.Flap transfer solved the problem.Postoperative follow-up period ranged from 4 to 30 months.The mallet deformity was corrected.There was no complaint of pain during finger movement.Active motion of involved fingers was satisfactory.According to the upper extremity functional evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association,the results were rated as good in 11 cases,fair in 1 case and poor in 1 case.The overall satisfactory rate was 92.3％.Conclusion The modified procedure of extensor tendon insertion reconstruction is convenient and practical.