[Closed percutaneous reduction and minimally invasive treatment of spastic hammery deformity].

Objective: To investigate the efficacy of percutaneous extensor tendon reconstruction in treating spastic hammery deformity. Methods: From February 2009 to July 2018, the clinicaldata of 36 patients with fresh sputum hammer fingers treated in Jinan People's Hospital were analyzed retrospectively. The tendon was percutaneously sutured with PDS Ⅱmonofilament suture and the distal end of the tendon was fixed to the base of the distal phalanx through the bone hole. Removal of the K-wire 6 weeks after the operation, the brace was used to fix the affected finger in the dorsal extension. For 8-10 weeks, only the brace was worn at night and the flexion and extension of the affected finger was gradually strengthened.The extension and flexion function of the interphalangeal joint of the finger was compared pre and post the operation with t test. Results: A total of 36 patients were enrolled but only 33 patientswere followed up for 6 to 15 months. The hammer-shaped deformity was corrected and there was no pain when moving fingers after the operation.The straightening angle of the interphalangeal joint of the finger improved from 46.2°±6.3° before surgery to 7.5°±0.6° after (t=35.12, P<0.05). The passive straightening angle decreased from 3.2°±0.3° before surgery to 0.9°±0.2° after (t=37.11, P<0.05). According to the Crawford functional assessment: excellent in 19 fingers, good in 10 fingers, can be in 4 fingers. The excellent rate was 87.9%. There was no knot exposure, skin necrosis and other complications. Conclusions: Percutaneous resection of the extensor tendon is fixed in the basal phalanx. It is a simple and feasible minimally invasive surgery for hammer-shaped deformity. It can obviously correct the hammer-shaped deformity and has fewer complications.目的： 探讨经皮指伸肌腱止点重建的修复方法，观察其临床效果。 方法： 回顾性分析2009年2月至2018年7月济南市人民医院收治的36例新鲜腱性锤状指患者的病例资料。经皮采用PDS Ⅱ单丝缝合线连续缝合伸肌腱并将肌腱远断端经骨孔固定于末节指骨基底部。6周拔除克氏针后使用支具固定患指于背伸位，8~10周仅夜间佩戴支具并逐步加强患指伸屈活动。应用t检验分析比较手术前后患指远指间关节伸屈功能。 结果： 入组36例，术后33例得到6~15个月随访，锤状指畸形矫正，患指活动无疼痛。患指远指间关节术前主动伸直角度由术前的46.2°±6.3°，改善至术后的7.5°±0.6°，差异有统计学意义（t=35.12，P<0.05)。被动伸直角度由术前的3.2°±0.3°，降至术后的0.9°±0.2°，差异有统计学意义（t=37.11，P<0.05)。按照Crawford功能评定法评定：优19指，良10指，可4指，优良率87.9%。无线结外露、皮肤坏死等并发症。 结论： 经皮将指伸肌腱止点重建固定于末节指骨基底是一种简便可行的微创手术，可明显纠正锤状指畸形，并发症少，是治疗锤状指畸形有效的方法。.