Acar M A, Güzel Y, Güleç A, Uzer G, Elmadağ M
Department of Orthopaedics and Traumatology, Medical School of Selcuk University, Konya, Turkey
Department of Orthopaedics and Traumatology, Ordu University, Ordu.
J Hand Surg Eur Vol. 2015 Oct;40(8):832-9. doi: 10.1177/1753193415581517. Epub 2015 Apr 16.
The aim of this retrospective study was to determine whether traumatic mallet fractures had better outcomes when treated by hook plate fixation (13 patients) or extension block pinning (19 patients). We assessed outcomes using Crawford's criteria; distal interphalangeal joint range of motion; the DASH score; and a visual analogue scale score for pain. We measured radiological parameters. No significant differences were observed in functional and clinical outcomes and in complications. Whereas the operative time was longer in the hook plate group, intraoperative fluoroscopy use, time to bone union and time to return to work were greater in the extension block group. Although the hook plate method is more technically demanding, it provides good stable reduction, earlier mobilization and an earlier return to work. The extension block pinning technique is easier and as effective but it requires greater peri-operative fluoroscopy. Level of evidence: Level III.
本回顾性研究的目的是确定创伤性锤状指骨折采用钩钢板固定（13例患者）或延长阻滞穿针固定（19例患者）治疗时，哪种方法的疗效更好。我们采用克劳福德标准、远端指间关节活动范围、DASH评分以及疼痛视觉模拟量表评分来评估疗效。我们测量了影像学参数。在功能和临床疗效以及并发症方面未观察到显著差异。虽然钩钢板组的手术时间较长，但延长阻滞组术中使用透视的次数更多、骨折愈合时间和恢复工作的时间更长。尽管钩钢板方法对技术要求更高，但它能提供良好的稳定复位、更早的活动以及更早返回工作岗位。延长阻滞穿针技术操作更简便且同样有效，但围手术期需要更多的透视。证据级别：三级。
