使用堆叠夹板或铝制指夹板对急性 Doyle Ⅳb 型骨槌状指进行保守治疗。
The use of Stack splint or aluminum finger splint in the conservative management of acute Doyle type IVb bony mallet finger.
机构信息
Department of Orthopaedics and Traumatology, Ankara City Hospital, Hand and Upper Extremity Surgery Division, Ankara, Turkey.
出版信息
J Orthop Sci. 2024 Jul;29(4):1091-1096. doi: 10.1016/j.jos.2023.07.020. Epub 2023 Aug 6.
BACKGROUND
The aim of this study was to compare the functional outcomes and direct costs of Stack splints and aluminum finger splints when used in the conservative management of patients with acute Doyle type IVb bony mallet finger.
METHODS
We retrospectively analyzed demographic and clinical characteristics, functional outcomes (using the Crawford classification, DIP flexion angles, and extension lag measurements), time to confirmation of union, and splint costs of 24 patients treated with aluminum finger splints (Group 1) and 20 patients treated with Stack splints (Group 2).
RESULTS
Of 44 patients, the median age was 38 (range, 20-59) years, 14 (32%) were smokers, 23 (52%) had fourth digit injuries, 32 (70%) had injuries to the dominant hand, 30 (68%) had a mechanism of injury of a fall, and median follow-up was 15 (range, 12-18) months; none of these differed significantly between Group 1 and Group 2 (all p > 0.05). In Group 1, functional outcomes were excellent and good in 14 (58%) and 10 (42%) patients, respectively; in Group 2 functional outcomes were excellent and good in 13 (62%) and 7 (35%) patients, respectively; and there was no significant difference between the groups. Median extension lag was 3.2° (range, 3.0°-3.5°) in group 1 and 3.4° (range, 3.2°-3.8°) in group 2, indicating no significant difference between groups. Complete union was confirmed radiographically in all patients. Per-patient cost was significantly lower for aluminum finger splints (0.208 TRY [US $0.03]) than for Stack splints (25 TRY [US $3.60]).
CONCLUSIONS
Good functional outcomes are possible with the use of either Stack or aluminum finger splints in patients with acute Doyle type IVb mallet finger, confirming that conservative management may be appropriate for these injuries. Direct costs of Stack splints are many times greater than those of aluminum splints, though the costs for both are relatively low.
LEVEL OF EVIDENCE
Therapeutic, Level III.
背景
本研究旨在比较 Stack 夹板和铝制指夹板在保守治疗急性 Doyle Ⅳb 型骨锤状指患者中的功能结果和直接成本。
方法
我们回顾性分析了 24 例接受铝制指夹板治疗的患者（第 1 组）和 20 例接受 Stack 夹板治疗的患者（第 2 组）的人口统计学和临床特征、功能结果（使用 Crawford 分类、DIP 屈曲角度和伸展滞后测量）、愈合确认时间和夹板成本。
结果
44 例患者的中位年龄为 38 岁（范围，20-59 岁），14 例（32%）为吸烟者，23 例（52%）为第 4 指损伤，32 例（70%）为优势手损伤，30 例（68%）的损伤机制为跌倒，中位随访时间为 15 个月（范围，12-18 个月）；第 1 组和第 2 组在这些方面均无显著差异（均 P>0.05）。第 1 组 14 例（58%）和 10 例（42%）患者的功能结果为优秀和良好；第 2 组 13 例（62%）和 7 例（35%）患者的功能结果为优秀和良好；两组间无显著差异。第 1 组的中位伸展滞后为 3.2°（范围，3.0°-3.5°），第 2 组为 3.4°（范围，3.2°-3.8°），两组间无显著差异。所有患者均经影像学证实完全愈合。每位患者的铝制指夹板费用（0.208 土耳其里拉[0.03 美元]）明显低于 Stack 夹板（25 土耳其里拉[3.60 美元]）。
结论
急性 Doyle Ⅳb 型锤状指患者使用 Stack 夹板或铝制指夹板均可获得良好的功能结果，这证实了保守治疗可能适用于这些损伤。Stack 夹板的直接成本是铝夹板的许多倍，尽管两者的成本都相对较低。
证据水平
治疗，III 级。
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