微型骨锚治疗手指近侧指间关节慢性掌板撕脱性损伤

目的介绍应用微型骨锚治疗手指近侧指间关节慢性掌板撕脱性损伤的手术治疗方法。方法对8例慢性掌板损伤病例,采用手术切开,掌板松解,Mitek微型骨锚重建撕脱掌板止点,术后早期进行屈伸功能锻炼。术后1年随访,随访内容包括手指近侧指间关节(proximal interphalangeal point,PIP)活动范围,关节疼痛,工作能力和患者主观满意度。结果本组患者术前PIP活动度为55.3°±27.8°,术后12个月为80.6°±17.6°(P<0.01)。3例优;3例良;2例一般;优良率达到75%。结论应用微型骨锚重建PIP关节撕脱掌板止点,恢复撕脱掌板正常的解剖学关系,能有效治疗慢性掌板撕脱伤;显著改善患指屈伸功能;缓解疼痛。

Application of Mitek macro anchor in the repair of chronic volar plate avulsion injury

Objective To introduce a new surgical procedure in treating chronic volar plate avulsion injury of the proximal interphalangeal joint with Mitek macro anchor.Methods Eight patients with chronic volar plate avulsion injury of the proximal interphalangeal joint were included in this study.Through a volar approach,the retracted volar plate was freed from scar and advanced distally.Mitek anchor was inserted to repair the avulted insertion of the volar plate on the volar basis of middle phalanx.Active motion was commenced 3 weeks postoperatively.Follow-up was performed 1 year later,and range of motion,pain,workload and patients’ satisfaction were evaluated.Results All patients had an improved range of motion following surgery as compared with that preoperatively(P<0.01).No intolerable pain was complained.Conclusion Surgical intervention of chronic volar plate avulsion injury using Mitek macro anchor can obtain excellent outcome of hand function recovery.