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[钢丝环扎术矫正近端指间关节融合治疗僵硬小趾畸形的前瞻性研究]

[Correction arthrodesis of the proximal interphalangeal joint with wire cerclage for rigid small toe deformities : a prospective study].

作者信息

Gutteck N, Lebek S, Radetzki F, Wohlrab D, Delank K-S

机构信息

Department für Orthopädie, Unfall- und Wiederherstellungschirurgie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 22, 061220, Halle, Deutschland.

出版信息

Orthopade. 2012 Dec;41(12):984-8. doi: 10.1007/s00132-012-1962-3.

Abstract

Deformities of the small toes often occur with complex forefoot deformities. Proximal interphalangeal joint arthrodesis is a reliable correction procedure for rigid flexed proximal interphalangeal joints. The most often performed technique by far is K-wire fixation; however, pin tract infections, malrotation due to deficient securing of the rotation and irritation of the metatarsophalangeal joints are common complications. By using a 0.4 mm wire cerclage an individual position of the proximal interphalangeal joint in slight flexion is enabled whereby good compression can be achieved and malrotation can be avoided. In 32 patients with 64 fixed claw or hammer toes such a proximal interphalangeal joint arthrodesis was performed. The follow-up time was 2 years. In all cases clinical and radiological osteotomy healing occurred 6 weeks postoperatively and there were no complications. This technically simple and cost-efficient procedure appears to be a good alternative to known proximal interphalangeal joint arthrodesis methods.

摘要

小趾畸形常与复杂的前足畸形同时出现。近端指间关节融合术是治疗僵硬性屈曲近端指间关节的可靠矫正方法。目前最常采用的技术是克氏针固定;然而,针道感染、由于旋转固定不足导致的旋转不良以及跖趾关节刺激是常见的并发症。通过使用0.4毫米钢丝环扎术,可以使近端指间关节处于轻度屈曲的个体位置,从而实现良好的加压并避免旋转不良。对32例患者的64个固定爪形趾或槌状趾进行了近端指间关节融合术。随访时间为2年。所有病例术后6周均实现临床和影像学截骨愈合,且无并发症。这种技术简单且成本效益高的手术似乎是已知近端指间关节融合术方法的良好替代方案。

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