UNASSIGNED: To compare the effectiveness of open reduction and hook plate fixation versus closed indirect reduction and dorsal extension blocking Kirschner wire fixation for bony mallet fingers.
UNASSIGNED: The clinical data of 68 patients with bony mallet finger who admitted between May 2019 and June 2022 were retrospectively analyzed. Among them, 33 cases were in the open group (treated with open reduction and hook plate fixation) and 35 cases were in the closed group (treated with closed indirect reduction and dorsal extension blocking Kirschner wire fixation). There was no significant difference between the two groups in terms of gender, age, the affected side, the affected finger, cause of injury, time from injury to operation, and Wehbé-Schneider classification ( P>0.05). The operation time, intraoperative fluoroscopy frequency, fracture healing time, time of returning to work, and postoperative complications were recorded and compared between the two groups. At 12 months after operation, visual analogue scale (VAS) score was used to assess the pain of the injured finger, active flexion range of motion and extension deficit of the distal interphalangeal joint (DIP) were measured by goniometer, and the effectiveness was assessed by Crawford criteria.
UNASSIGNED: All patients in the two groups were followed up 12-26 months, with an average of 15 months. There was no significant difference in the follow-up time between the closed group and the open group ( P>0.05). The operation time in the closed group was shorter than that in the open group, and the intraoperative fluoroscopy times, the fracture healing time, and the time of returning to work in the closed group were more than those in the open group, and the differences were significant ( P<0.05). In the closed group, there were 5 cases of pinning tract infection and 3 cases of small area pressure ulcer skin necrosis on the dorsal side of the finger, which were cured after intensive nursing and dressing change. Local nail depression deformity occurred in 7 cases in the open group, and the deformity disappeared after removal of plate. The incisions of the other patients healed uneventfully without complications such as infection, skin necrosis, exposure of the internal fixation, or nail deformity. There was no significant difference in the incidence of skin necrosis between the two groups ( P>0.05), but the differences in the incidence of infection and nail deformity between the two groups were significant ( P<0.05). There was no significant difference in VAS score, DIP active flexion range of motion, DIP extension deficiency, or Crawford criteria evaluation between the two groups at 12 months after operation ( P>0.05). At last follow-up, there was no DIP osteoarthritis and joint degeneration in both groups.
UNASSIGNED: Open reduction and hook plate fixation versus closed indirect reduction and dorsal extension blocking Kirschner wire fixation have their own advantages and disadvantages, but both of them have good results in the treatment of bony mallet fingers. Open reduction and hook plate fixation is recommended for young patients with bony mallet fingers who are eager to return to work.
UNASSIGNED: 比较切开复位钩状钢板固定与闭合间接复位背侧伸直阻挡克氏针固定治疗骨性锤状指的临床疗效。.
UNASSIGNED: 回顾分析 2019年5月—2022年6月收治且符合选择标准的68例骨性锤状指患者临床资料。其中切开组33例(采用切开复位钩状钢板固定),闭合组35例(采用闭合间接复位背侧伸直阻挡克氏针固定治疗)。两组患者性别、年龄、患侧侧别、伤指指别、致伤原因、受伤至手术时间及Wehbé-Schneider分型比较差异均无统计学意义( P>0.05)。记录并比较两组患者手术时间、术中透视次数、骨折愈合时间、返岗工作时间及并发症发生情况;术后12个月采用疼痛视觉模拟评分(VAS)评定伤指疼痛情况,量角器测量手指远侧指间关节(distal interphalangeal joint,DIP)主动屈曲活动度及伸直欠缺度,采用Crawford标准评定临床疗效。.
UNASSIGNED: 两组患者均获随访,随访时间12~26个月,平均15个月;闭合组和切开组随访时间比较差异无统计学意义( P>0.05)。闭合组手术时间短于切开组,术中透视次数、骨折愈合时间及返岗工作时间均多于切开组,差异均有统计学意义( P<0.05)。闭合组发生针道感染5例、末节指背侧皮肤小面积压疮坏死3例,经加强护理换药后痊愈;切开组发生7例指甲局部凹陷畸形,拆除内固定钢板后畸形消失;其余患者切口均顺利愈合,无感染、皮肤坏死、内固定物外露、指甲畸形等并发症发生。两组患者皮肤坏死发生率比较差异无统计学意义( P>0.05),感染和指甲畸形发生率比较差异有统计学意义( P<0.05)。术后12个月,两组VAS评分、DIP主动屈曲活动度、DIP伸直欠缺度及Crawford标准评价比较差异均无统计学意义( P>0.05)。 末次随访时两组患者均无DIP骨关节炎及关节退行性改变发生。.
UNASSIGNED: 切开复位钩状钢板固定与闭合间接复位背侧伸直阻挡克氏针固定治疗骨性锤状指虽各有利弊,但均取得了较好治疗效果;对于急于重返工作岗位的年轻骨性锤状指患者建议采用切开复位钩状钢板固定。.