| Objective:To compare the clinical efficacy of external fixation with Kirschner wire combined with anchor nail in the treatment of tendinous mallet fingers,and provide a reasonable treatment plan for clinical treatment.Methods:The Department of Orthopaedic Micro-hand surgery of the second Hospital of Shanxi Medical University from January 2017 to January 2022 was selected.According to the medical history,signs and auxiliary examinations,80 patients diagnosed as tendinous hammering fingers were selected as the object of study.According to the different treatment methods,the patients were divided into conservative treatment group(n = 40)and operation group(n = 40).In the conservative treatment group,there were 23 males and 17 females,aged from 20 to 66 years(mean 38.35 years).The injured fingers were index finger(n = 4),middle finger(n = 10),ring finger(n = 15)and little finger(n= 11).The time from injury to treatment was 1: 31 days.In the surgical treatment group,there were 19 males and 21 females,aged from 17 to 69 years(mean 41.8 years).The injured fingers were index finger(n = 6),middle finger(n = 11),ring finger(n = 13)and little finger(n = 10).The time from injury to treatment was 1 to 90 days.During the follow-up,the visual analog score(VAS,visual analogue scale)was collected to evaluate the pain,the under extension of the distal interphalangeal joint,the range of motion(AROM,active range of motion)and the occurrence of complications of the distal interphalangeal joint,and the prognosis of the affected finger was evaluated by Crawford.All patients received informed consent of patients and their families before treatment,and all treatment operations were performed by the same doctor.The collected data were compared and analyzed by statistical software SPSS26.0.Results:According to the Crawford evaluation criteria,the excellent and good rate was75.0% in the conservative treatment group and 87.5% in the surgical treatment group,and the difference was not statistically significant(P>0.05).There was significant difference(P<0.05)in VAS score between the two groups at the last follow-up after treatment.There was a significant correlation between the time from injury to treatment and the curative effect in the conservative treatment group(P <0.05),but there was no significant correlation between the age and the curative effect in the conservative treatment group(P>0.05).There was no significant correlation between injury to treatment time,age and curative effect in surgical treatment group(P >0.05).Conclusion:For the treatment of tendinous hammer finger,external fixation brace and Kirschner wire combined anchor have good clinical effect,which can significantly improve the deformity and flexion and extension function of the affected finger,and restore the normal life and working ability of the patients.For the long-term effect,surgical treatment is more able to relieve pain.Conservative treatment with external fixation brace is recommended for fresh tendinous hammer fingers,and direct surgical treatment is recommended for patients with injuries of more than 3 weeks. |
