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锚钉技术治疗糖尿病与非糖尿病患者腱性锤状指畸形的疗效分析
作者姓名:周彤  尚运涛  马莹莹  张延祠  李军勇
作者单位:1. 063000 唐山市第二医院手外科2. 050000 石家庄市第二医院骨科3. 050000 石家庄,中国人民解放军联勤保障部队第980(白求恩国际和平)医院急诊科
基金项目:石家庄市科学技术研究与发展指导计划(191460603)
摘    要:目的探讨应用锚钉技术治疗糖尿病与非糖尿病患者腱性锤状指畸形的疗效,评估锚钉技术在治疗糖尿病患者腱性锤状指畸形的临床可行性。 方法前瞻性收集石家庄市第二医院和唐山市第二医院的腱性锤状指畸形糖尿病(试验组)与非糖尿病(对照组)患者各30例,试验组男性15例,女性12例,平均年龄(44.54±4.55)岁,对照组男性13例,女性13例,平均年龄(43.63±4.37)岁,均应用锚钉技术治疗。术后比较两组患者伤口愈合时间;2、3,4个月的患指屈伸运动功能;肌腱愈合情况;并发症发生情况。 结果试验组30例,其中3例失去随访;对照组30例,其中4例失去随访。伤口愈合时间:试验组平均(14.0±1.0)d;对照组平均(13.0±1.1)d,两组比较差异无统计学意义(t=0.087,P>0.05)。末次随访时MP、PIP,DIP屈伸活动度分别为试验组:(89.7±2.4)°、(84.2±5.4)°,(76.3±5.2)°;对照组:(89.0±3.2)°、(84.0±5.3)°,(75.3±5.2)°,两组比较差异分别无统计学意义(t=1.325,P>0.05)、(t=1.079,P>0.05),(t=1.553,P>0.05)]。手运动功能TAM分级:试验组优23例,良3例,可1例;对照组优22例,良2例,可2例,两组比较差异无统计学意义(χ2=0.343,P>0.05)。肌腱彩超提示,两组患者均腱骨愈合良好。两组患者术后均无明显并发症发生,可从事正常工作及生活。 结论锚钉技术可有效防止伸肌腱粘连,使患指获得良好的屈伸运动功能,术后并发症少,同样可以用于糖尿病患者腱性锤状指畸形的治疗。

关 键 词:锚钉技术  糖尿病  锤状指  伸肌腱  止点  
收稿时间:2021-01-22

Analysis of the efficacy of anchor technique in the treatment of tendinous mallet finger deformity in patients with diabetes and non-diabetes
Authors:Tong Zhou  Yuntao Shang  Yingying Ma  Yanci Zhang  Junyong Li
Institution:1. Department of Hand Surgery, the Second Hospital of Tangshan, Tangshan 063000, China2. Department of Orthopedics, the Second Hospital of Shijiazhuang City, Shijiazhuang 050000, China3. Department of Emergency, 980 hospital of PLA joint logistics support forces, Shijiazhuang 050000, China
Abstract:ObjectiveTo analyze the efficacy of anchor technique in the treatment of tendinous mallet finger deformity in diabetic and non-diabetic patients and evaluate the clinical feasibility of anchor technique in the treatment of tendinous mallet finger deformity in diabetic patients. MethodsProspectively collecting 30 diabetic (treatment group) and 30 non-diabetic (control group) patients with tendinous mallet finger deformity who were treated with anchor technique in the Second Hospital of Shijiazhuang and the Second Hospital of Tangshan. After operation, the wound healing time, the affected finger function of flexion and extension at 2, 3 and 4 months, the tendon healing, the complications were compared in 2 groups. ResultsAmong the 30 cases in the treatment group, 3 cases were lost follow-up, while 4 cases lost follow-up in the control group. The average wound healing time was (14.0±1.0) days in the treatment group while (13.0±1.1) days in the control group, there was no significant difference between the two groups (t=0.087, P>0.05). At the last follow-up, the range of flexion and extension of MP, PIP and DIP were (89.7±2.4)°, (84.2±5.4)° and (76.3±5.2)° respectively while the control group were (89.0±3.2)°, (84.0±5.3)°, (75.3±5.2)° respectively, there was no significant difference between the two groups (t=1.325, P>0.05), (t=1.079, P>0.05), (t=1.553, P>0.05)]. According to the TAM classification of hand motor function, 23 cases were excellent, 3 cases were good and 1 case was fair in the treatment group, while 22 cases, 2 cases and 2 cases in the control group, there was no significant difference between the two groups (χ2=0.343, P>0.05). Tendon ultrasound showed that the tendon and the bone healed well in both groups. There were no obvious postoperative complications in the two groups and they could engage in normal work and life. ConclusionsAnchor technique can effectively prevent the adhesion of extensor tendon, obtain good flexion and extension function of the affected finger and reduce postoperative complications. It can also be used for the treatment of tendinous mallet finger deformity in patients with diabetes.
Keywords:Anchor technique  Diabetic  Tendinous mallet finger deformity  Extensor tendon  Attachment  
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