[1]尚运涛,周彤,梁京,等.不同手术方式治疗糖尿病患者手指屈肌腱止点断裂的临床研究[J].中华老年骨科与康复电子杂志,2020,(06):340-345.[doi:10.3877/cma.j.issn.2096-0263.2020.06.005]
 Shang Yuntao,Zhou Tong,Liang Jing,et al.Clinical study on different surgical methods to treat the attachment rupture of the flexor tendon of finger in diabetic patient[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2020,(06):340-345.[doi:10.3877/cma.j.issn.2096-0263.2020.06.005]
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不同手术方式治疗糖尿病患者手指屈肌腱止点断裂的临床研究()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2020年06期
页码:
340-345
栏目:
骨与创伤
出版日期:
2020-12-05

文章信息/Info

Title:
Clinical study on different surgical methods to treat the attachment rupture of the flexor tendon of finger in diabetic patient
作者:
尚运涛1周彤2梁京3王浩汀1李军勇1
050000 石家庄市第二医院骨科1; 063000 唐山市第二医院手外科2; 050000 石家庄市第六医院中医儿科3
Author(s):
Shang Yuntao1 Zhou Tong2 Liang Jing3 Wang Haoting1 Li Junyong1
1Department of Orthopedics, the Second Hospital of Shijiazhuang City, Shijiazhuang 050000, China; 2Department of Hand Surgery, the Second Hospital of Tangshan, Tangshan 063000, China; 3Department of TCM Pediatrics, Shijiazhuang Municipal Women and Children Health Care Hospital, Shijiazhuang 050000, China
关键词:
微型带线锚钉 糖尿病 屈肌腱 止点断裂
Keywords:
Mini-anchor Diabetes Flexor tendon Attachment rupture
DOI:
10.3877/cma.j.issn.2096-0263.2020.06.005
文献标志码:
A
摘要:
目的 分析传统术式(皮下隧道细钢丝加压缝合术)及微型带线锚钉修复术治疗外伤性手指屈肌腱止点断裂糖尿病患者的疗效,以评估微型带线锚钉修复糖尿病患者屈肌腱止点断裂的临床疗效及可行性。方法 前瞻性收集石家庄市第二医院和唐山市第二医院的外伤性手指屈肌腱止点断裂的糖尿病患者60例,随机分为试验组(微型带线锚钉修复)及对照组(皮下隧道细钢丝加压缝合术)。两组患者术后2、3、4个月行患指功能、伤口愈合评定,比较行两种术式后手指屈伸功能。结果 60例患者均获得随访,末次随访时试验组与对照组相比MP和PIP屈伸活动度,差异无统计学意义;试验组与对照组相比DIP屈伸活动度和TAM值差异有统计学意义,且试验组DIP屈伸活动度和TAM值大于对照组;手运动功能TAM分级:试验组优23例,良6例,可1例;对照组优22例,良6例,可2例。结论 微型带线锚钉修复糖尿病患者屈肌腱止点断裂能够有效地防止和减少肌腱粘连,显著提高患指术后的屈伸功能,是一种有效的、可行的术式,较传统术式具有较大优势。
Abstract:
Objective To analyze the effect of traditional surgical method (steel wire suture through subcutaneous tunnel) and the method of mini-anchor repair to treat the attachment rupture of finger flexor tendon after hand injury in diabetic patient and confirm the advantage of miniature anchor in the treatment of tendon rupture in patient with diabetes. Methods Prospective collection of sixty diabetic patients with rupture of finger flexor tendon in The Second Hospital of Shijiazhuang and The Second Hospital of Tangshan. Two groups were randomly divided, the experimental group (mini-anchor repair) and the control group (steel wire suture through subcutaneous tunnel). The function of the affected finger and wound healing were evaluated 2, 3, 4 months after surgery in two groups and the flexion and extension functions of the finger were compared between the two groups. Results Sixty patients were all followed up. At the last follow-up, there was no significant difference in flexion and extension ROM of MP and PIP between the experimental group and the control group. Compared with the control group, the flexion and extension ROM of DIP and TAM values in the experimental group were significantly different and the flexion and extension ROM of DIP and TAM values in the experimental group were significantly higher than those in the control group. TAM classification of hand motor function: 23 cases in experimental group were excellent, 6 cases were good, 1 case was fair. 22 cases in control group were excellent, 6 cases were good, 2 cases were good. Conclusion Repairing the rupture of flexor tendon attachment with mini-anchor can effectively prevent and reduce tendon adhesion, significantly improve the function of finger flexion and extension after surgery. It is an effective and feasible method and has relatively?large advantages over traditional surgery.

参考文献/References:

1 Ji X, Reisdorf RL, Thoreson AR, et al. Surface modification with chemically modified synovial fluid for flexor tendon Reconstruction in a canine model in vivo [J]. J Bone Joint Surg Am, 2015, 97(12): 972-978.2 Shalumon KT, Sheu C, Chen CH, et al. Multi-functional electrospun antibacterial core-shell nanofibrous membranes for prolonged prevention of post-surgical tendon adhesion and inflammation [J]. Acta Biomater, 2018, 72: 121-136.3 Jy C, Chen T, Awad H, et al. Comparison of an all-inside suture technique with traditional pull-out suture and suture anchor repair techniques for flexor digitorum profundus attachment to bone [J]. J Hand Surg Am, 2013, 38(6): 1084-1090.4 姜德欣, 李大为, 刘遵勇, 等. 微型骨锚在指深屈肌腱止点重建中的应用 [J]. 中华手外科杂志, 2010 (3): 133.5 马涛, 姜宗圆, 夏江, 等. 指深屈肌腱Ia和Ib区损伤的重建和防粘连技术应用 [J]. 中华显微外科杂志, 2013 (6): 597-599.6 崔军, 纪威, 李辉, 等. 2006-2014年宁波市2型糖尿病发病趋势分析 [J]. 中国农村卫生事业管理, 2016, 36(9): 1167-1169.7 Lange S, Diehm C, Darius H, et al. High prevalence of peripheral arterial disease and low treatment rates in elderly primary care patients with diabetes [J]. Exp Clin Endocrinol Diabetes, 2004, 112(10): 566-573.8 潘琦, 郭立新, 肖琛嫦, 等. 湖北省糖尿病患者血糖控制现状与影响因素的调查分析 [J]. 中国糖尿病杂志, 2016, 24(6): 481-485.9 高赟, 冉兴无. 警惕糖尿病性周围动脉病变漏诊——不容忽视的危害 [J]. 临床误诊误治, 2017, 30(10): 1-3.10 郭尔斐, 宋亮亮, 张斌, 等. 微型锚钉修复指深屈肌腱止点断裂的临床研究 [J]. 现代中西医结合杂志, 2017, 26(7): 754-756.11 Han K, Yao J, Yin X, et al. Review on the prevalence of diabetes and risk factors and situation of disease management in floating population in China [J]. Glob Health Res Policy, 2017, 2: 33.12 杨琪, 查云飞. 糖尿病合并外周动脉疾病骨骼肌微血管病变影像学研究进展 [J]. 磁共振成像, 2020, 11(5): 390-393.13 温婷, 袁锋, 尚茹茹, 等. 糖尿病与动脉粥样硬化相关机制的研究 [J]. 中华临床医师杂志:电子版, 2016, 10(7): 999-1002.14 高璐, 秦明照. 老年糖尿病患者代谢综合征与外周动脉疾病的相关性分析 [J]. 中华老年心脑血管病杂志, 2020, 20(9): 917-919.15 丁印勇, 宋新颜, 宋滨东. 研究糖尿病患者周围动脉硬化斑块的超声影像特征 [J]. 影像研究与医学应用, 2020, 4(7): 54-55.16 郭红涛, 陶忠生, 冯亚高, 等. 克氏针远指间关节屈曲固定加牵引治疗小儿屈指肌腱止点断裂 [J]. 临床骨科杂志, 2016, 19(1): 125-126.17 崔满意, 田恒进, 王志勇, 等. 皮下缝线穿骨孔固定法重建指深屈肌腱止点 [J]. 中华手外科杂志, 2019, 35(2): 106-107.18 郑波, 丁小珩, 刘育杰, 等. 罕见指深屈肌腱撕脱性损伤的分型诊断及治疗 [J]. 中华手外科杂志, 2016, 32(5): 355-357.19 梁晨, 杨寅, 张延平, 等. 阻挡针技术治疗急性闭合性末节指骨肌腱止点撕脱性骨折的临床效果观察 [J]. 骨科, 2019, 10(6): 521-525.20 缪华, 李金付, 王松明, 等. 经骨道固定的肌腱缝线在指深屈肌腱止点重建中的应用 [J]. 实用手外科杂志, 2018, 32(4): 469-470.21 何仁高, 胡军祖, 粟玉斌, 等. 缝合锚钉修复四肢肌腱止点区断裂伤 [J]. 临床骨科杂志, 2016, 19(5): 613-613.22 熊革, 肖滋润, 张春林, 等. 板钉固定治疗指深屈肌腱止点撕脱骨折的疗效分析 [J]. 中华手外科杂志, 2017, 33(1): 29-31.23 殷超, 郝增涛, 王小龙, 等. 改良加压克氏针阻挡固定治疗Ⅲ型指深屈肌腱止点撕脱骨折 [J]. 中华手外科杂志, 2019, 35(6): 463-464.

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备注/Memo

备注/Memo:
基金项目:石家庄市科学技术研究与发展指导计划(191460603)
更新日期/Last Update: 2020-12-31