Hooijboer P G, Vuursteen P J
Afd. Chirurgie, Sint Lucas Ziekenhuis, Amsterdam.
Ned Tijdschr Geneeskd. 1990 Jan 27;134(4):173-7.
In a retrospective study the results of conservative and operative treatment of mallet fingers (n = 86) were evaluated. The results of Stack splint therapy (n = 59) were disappointing. There was a good result in only 32%. Mallet fingers associated with avulsion fracture (n = 24) give better results (42% 'good') than mallet fingers due to tendon rupture (n = 35) (26% 'good'). With operative treatment (n = 27), consisting of tenodermodesis in combination with internal Kirschner wire fixation, there was a good result in 89%. Surgery was used not only if conservative treatment failed, but also as primary therapy. In case of tendogenous mallet finger the results of surgery are significantly better than those of conservative therapy (p less than 0.00001). Based on our retrospective study we suggest that the tenodermodesis with K-wire fixation be considered not only in cases where conservative treatment fails, but also as primary treatment of tendogenous mallet finger. In mallet finger with avulsion fracture conservative treatment appears to be the treatment of choice.
在一项回顾性研究中，对86例锤状指的保守治疗和手术治疗结果进行了评估。Stack夹板治疗（59例）的结果令人失望。仅有32%的治疗效果良好。伴有撕脱骨折的锤状指（24例）的治疗效果（42%“良好”）优于肌腱断裂所致锤状指（35例）（26%“良好”）。采用腱膜固定术联合克氏针内固定的手术治疗（27例），89%的治疗效果良好。手术不仅用于保守治疗失败的情况，也作为初始治疗方法。对于肌腱性锤状指，手术效果明显优于保守治疗（p<0.00001）。基于我们的回顾性研究，我们建议，克氏针固定的腱膜固定术不仅应在保守治疗失败的情况下考虑应用，也应作为肌腱性锤状指的初始治疗方法。对于伴有撕脱骨折的锤状指，保守治疗似乎是首选治疗方法。
