摘要
目的:探讨应用铍针经皮多节段切断微创治疗掌腱膜挛缩症的临床效果。方法:本组16例(25指),其中男11例,女5例;其中中指4指,环指12指,小指9指;双手发病2例,单手发病14例,其中左手8例,右手6例;年龄48~79岁,平均58.5岁。发病时间1~15年,平均5.5年。体力劳动12例,非体力劳动4例,均为汉族,均无掌腱膜挛缩症家族史,有烟酒嗜好者9例,有高血压病史者6例,有糖尿病史者3例。按照Meyerding分期:0期1例,Ⅰ期1例,Ⅱ期10例,Ⅲ期4例,Ⅳ期0例。结果:本组切口愈合时间7~14 d,平均10 d,其中3指切口皮肤在松解过程中开裂3~4 mm,术后予以换药后14 d均愈合,未出现皮肤坏死及伤口感染并发症。24指治疗后掌腱膜挛缩完全或基本解除,掌指关节、指间关节伸直受限0°~10°,其中手指伸直功能恢复正常22指,伸直功能改善75%以上者2指,复发1指。根据Adam疗效评定标准评价掌腱膜挛缩症术后功能:优22指,良2指,差1例,患者均对治疗结果表示满意。结论:应用铍针经皮多节段切断微创治疗掌腱膜挛缩症是一种操作简单、创伤小、行之有效的方法。
Objective：To investigate the clinical efficacy of Pi needle percutaneous multi segmental fasciotomy as a minimally invasive treatment for Dupuytren＇s contracture. Methods：Sixteen patients（25 fingers：4 middle fingers,12 ring fingers,9 little fingers） were involved in the study,including 11 males and 5 females. There were 2 cases on both hands and 14 cases of single hand disease,including 8 cases of left hand and 6 cases of right hand. The age ranged from 48 to 79 years old,with a mean age of 58.5 years old. The duration of the disease ranged from 1 to 15 years,with a mean time of 5.5 years. There were 12 cases of physical labor,4 cases of non physical labor,with no family history of palmar fascial contracture. There were 9 cases of tobacco and alcohol addicts,6 cases with hypertension history,and 3 cases of diabetes mellitus. According to Meyerding classification,1 case was stage 0,1 case was stage Ⅰ,10 cases were stage Ⅱ,4 cases were stage Ⅲ and 0 case was stage Ⅳ. The postoperative function of Dupuytren＇s contracture patients was evaluated according to Adam efficacy evaluation criteria. Results：The time of incision healing time ranged from 7 to 14 days,10 days on average. The 3 fingers incision skin cracked 3 to 4 mm during the loosening process,and 14 days after dressing changed,no skin necrosis and wound infection complication occurred. After treatment,fascia contracture of 24 fingers completely or almost disappeared. Limited extension of metacarpophalangeal joint and interphalangeal joint ranged from 0 to 10 degrees,22 fingers showed normal function of finger extension,2 fingers had more than 75% elongation function,and 1 finger recurred. According to the evaluation of Adam evaluable standard of curative effect on the postoperative function of Dupuytrens＇ s contracture ：22 fingers got an excellent result,2 fingers good and1 finger recurred. The patients were satisfied with the results of the treatment. Conclusion：Pi needle percutaneous multi segmental fasciotomy for the treatment of Dupuytren ＇s contracture is a simple,minimally invasive and effective method.
作者
陈旭辉
王西迅
CHEN Xu-hui;WANG Xi-xun(Department of Orthopaedics ,Xin＇ an lnternational Hospital of Zhejiang, Jiaxing 314000, Zhejiang, China)
出处
《中国骨伤》
CAS
2018年第6期514-517,共4页
China Journal of Orthopaedics and Traumatology
关键词
掌腱膜挛缩
针刺疗法
铍针
Dupuytren contracture
Acupuncture therapy
Pi needle
