肌腱线经隧道双缝合法治疗特殊类型锤状指

目的介绍一种治疗特殊类型锤状指的方法。方法对32例手指伸肌腱止点离断的患者给予肌腱线经隧道双缝合法治疗，即在远节指骨基底部钻孔，远侧指间关节用直径1．0mm克氏针固定过伸位10°～15°，两根肌腱线反向穿过骨隧道后分别在肌腱断端止点近端做“8”字缝合及经止点背侧单圈缝合。术后6周拔除克氏针内固定开始末节指间关节功能锻炼。结果术后随访4-12个月（平均6．8个月），32例均一期愈合，无1例发生切口感染、肌腱再断裂、皮肤坏死。按TAM系统评定方法评定：优19例，良13例．优良率为100％。结论肌腱线经隧道双缝合法是临床上治疗特殊类型锤状指的一种简单、疗效确切、经济实用的治疗方法。

Application of double suture of tendon line through tunnel to treat special mallet fingers

Objective To introduce a method for treating special mallet fingers. Methods 32 cases with mallet finger were treated with this procedure.Drilling on the basilar part of the distal phalanx, the distal interphalangeal joint was locked in 10-15 degrees extension by 1.0 mm diameter Keith needle.Two tendon lines were through the tunnel of the basilar part of the distal phalanx on opposite direction, the proximal end of broken tendons were sutured ＂8＂means with one tendon hne, the extensor apparatus insertion were sutured circle means with another tendon line.function practice of the distal phalanx could be performed when the Keith needle was removed after 6 weeks. Results Postoperative follow-up visit ranged from 4 to 12 months （with an average of 6.8 months）. All cases were primary intention healing. There was no infection of incisional wound, no tendon rupture again and necrosis of skin. According to TAM evaluation criteria, the results were rated as excellent in 19 cases and good in 13 cases.The overall satisfactory rate was 100%. Conclusion Using double suture of tendon hne through tunnel to treat special mallet fingers is an easy, effective, economical and practical way.