2种手术方法治疗骨性锤状指的疗效比较

目的观察比较克氏针挤压复位固定与微型骨锚治疗骨性锤状指的临床疗效。方法收集2010年3月至2013年8月所有末节指骨撕脱性骨折并接受手术治疗的患者48例51指,所有患者按随机数字表法分成A、B 2组,A组（24例25指）采用克氏针挤压复位固定骨折块治疗;B组（24例26指）采用微型骨锚重建指伸肌腱I区止点,均随访3-6个月,按TAM系统方法评定治疗效果。结果 A组24例25指,随访23指,平均随访116 d,按TAM系统评定方法,优14指,良6指,可2指,差1指,优良率86.96%。B组24例26指,随访24指,平均随访108 d,按TAM系统评定方法,优13例,良9例,可1例,差1例,优良率84.62%。2组功能优良率差异无统计学意义（P〉0.05）。A组2例出现术后并发症,并发症发生率8.70%,B组6例出现术后并发症,并发症发生率为20.83%,A组术后并发症发生率明显低于B组（P〈0.05）。结论克氏针挤压复位固定法临床疗效可靠,并发症少,手术费用低。

Comparison of Clinical Efficacy of Two Surgical Procedures for Mallet Fingers

Objective To compare the clinical efficacy of Kirschner wire fixation and miniature bone anchor in the treatment of mallet fingers. Methods Forty-eighty patients who received operation for the avulsion fracture of the distal phalanx（51 fingers） between March 2010 and August 2013 were randomly divided into two groups. The group A（24 patients, 25 fingers） was treated with Kirschner wire fixation. The group B（24 patients, 26 fingers） was treated with the reconstruction of terminal extensor tendon with miniature bone anchor. All patients were followed up for 3-6 months and the curative efficacies were evaluated by using TAM system. Results In group A, 23 fingers were followed up for an average of 116 days. According to TAM system, the function was excellent in 14 fingers, good in 6, fair in 2 and poor in 1. In group B, 24 fingers were followed up for an average of 108 days. According to TAM system, the function was excellent in 13 fingers, good in 9, fair in 1 and poor in 1. The choiceness rate was 86.96% in group A and 84.62% in group B. There was no significant difference in the choiceness rate between the two groups（P〉0.05）. However, the incidence of postoperative complications in group A（8.70%, 2 patients） was significantly lower than that in group B（20.83%, 6 patients）（P〈0.05）.Conclusion Kirschner wire fixation is reliable for treating mallet fingers and allows few complications and low costs.