回顾性研究闭合性腱锤状指手术治疗与保守治疗的临床疗效比较

Xiaoling Zhou, Xue-yuan Li, Hao-liang Hu, Miao Yu, Yi Li
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摘要

目的比较短指套手术治疗和保守治疗闭合性腱槌指的临床疗效。方法2014年10月至2016年12月,对104例闭合性腱槌指患者进行治疗。其中54例接受手术治疗(A组),50例接受短指支架保守治疗(B组)。所有患者均进行了临床随访。记录受影响手指的活动范围、疼痛和并发症。根据Abouna和Brown功能评价标准对临床疗效进行评价。对两组患者的临床疗效进行统计学分析。结果A组随访5~12个月,平均6.3个月,B组随访4~14个月,均7.1个月。根据Abouna和Brown功能评价标准,结果优30例,良15例,差9例,A组优良率83.3%;B组优28例,良16例,差6例,优良率88.0%,A组术后并发伤口感染、异物反应、甲床畸形等并发症,B组治疗后仅1例出现轻微压痛,经适当护理后恢复正常。结论短指支架保守治疗闭合性腱槌指的临床疗效与手术治疗无明显差异。然而,保守治疗具有操作简单、成本低、并发症少的优点。关键词:肌腱损伤;比较有效性研究;Mallet finger;保守治疗;手术治疗
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Retrospective study for clinical efficacy comparison of operative treatment and conservative treatment by short finger brace for closed tendinous mallet finger
Objective To compare the clinical efficacy of operative treatment and conservative treatment by short finger brace for closed tendinous mallet finger. Methods From October 2014 to December 2016, 104 patients with closed tendinous mallet finger were treated. Among them, 54 patients underwent operative treatment (group A) and 50 patients underwent conservative treatment by short finger brace (group B). All the patients were followed up clinically. The active range of motion, pain and complications of affected fingers were recorded. The clinical efficacy was evaluated according to Abouna and Brown functional evaluation criteria. The difference of clinical efficacy between the two groups was statistically analyzed. Results The follow-up time of group A was 5 to 12 months with an average of 6.3 months, while that of group B was 4 to 14 months with an average of 7.1 months. According to Abouna and Brown functional evaluation criteria, the results were rated as excellent in 30 cases, good in 15 cases, poor in 9 cases with the excellent and good rate being 83.3% in group A; while the results were rated as excellent in 28 cases, good in 16 cases, poor in 6 cases with the excellent and good rate being 88.0% in group B. There was no significant difference in the excellent and good rate between the two groups, and there was no significant difference in the degree of pain between the two groups (P>0.05). The operation of group A was complicated with complications such as wound infection, foreign body reaction, nail bed deformity and so on. In group B, only one case had slight pressure sore after treatment, which returned to normal after proper nursing. Conclusion The clinical efficacy of conservative treatment by short finger brace for closed tendinous mallet finger is not significantly different from that of operative treatment. However, the conservative treatment has the advantages of simple operation, low cost and fewer complications. Key words: Tendon injuries; Comparative effectiveness research; Mallet finger; Conservative treatment; Operative treatment
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