| Objective:To compare the clinical efficacy of conservative treatment with external fixation and surgical treatment of tendinous mallet finger,to explore the respective clinical advantages of conservative and surgical treatment,to find out the best treatment plan for tendinous mallet finger,and finally to achieve the goal of individualized treatment.Methods:A total of 78 cases were collected from the Department of Burn and Plastic Surgery of Yan’an University Affiliated Hospital from January 2018 to January2020.A total of 78 cases were collected,of which 38 were treated conservatively and 40 were treated surgically.There were 52 males and 26 females,ranging in age from 15 to67 years old,with an average age of 41.29±13.45 years.Injured hands: 35 left hands and 43 right hands.Injured fingers: 15 cases of index finger,25 cases of middle finger,23 cases of ring finger,and 15 cases of little finger.Injury factors: 15 cases of crush injury,22 cases of fall injury,24 cases of poke injury,and 17 cases of sprain injury.Follow-up time was 6 months and 12 months after treatment.During the follow-up,data such as underextension of the distal interphalangeal joint,active range of motion（AROM,active range of motion）,complications,and visual analogue scale（VAS,visual analogue scale）of the affected fingers were mainly collected,and they passed the Crawford curative effect criteria.Assess the prognosis of the patient’s finger.All treatments are performed by the same senior doctor in the department under the condition of being informed before treatment and obtaining the consent of the patients and their families.The collected data were analyzed by statistical software SPSS 25.0.Results: According to Crawford’s evaluation criteria,40 cases had excellent recovery effect,20 cases were good,13 cases were fair,and 5 cases were poor.After statistical analysis,all patients had a certain degree of limitation of extension and flexion of the distal interphalangeal joint of the affected finger before diagnosis and treatment,and the underextension angle of the distal interphalangeal joint in the conservative treatment group was（32.92±6.01）,the underextension angle of the distal interphalangeal joint in the surgical treatment group was（34.18±5.71）,and there was no significant difference in the underextension angle of the distal interphalangeal joint between the two groups before treatment;At 6 months and 12 months after treatment,the underextension angle of the distal interphalangeal joint in the two groups was smaller than that before treatment,and the difference was statistically significant（P<0.05）;Before and after treatment,there was no significant difference in the underextension angle of the distal interphalangeal joint of the affected finger between the conservative treatment group and the surgical treatment group（P>0.05）.The active range of motion of the distal interphalangeal joint in the conservative treatment group was（58.74±7.44）in the 12 months follow-up after treatment,which was higher than that at 6 months after treatment（53.87±5.78）;The active range of motion of the distal interphalangeal joint was（61.23±8.95）in the surgical treatment group at 12 months after operation,which was higher than that at 6 months after treatment（56.35±7.83）.However,there was no significant difference in the active range of motion of the distal interphalangeal joint between the two groups at 6 months and 12 months after treatment（P>0.05）.Among the patients who were followed up,1 case of nail malunion and 2 cases of local wound redness and swelling complicated by infection.The visual analogue scale of the two groups at 6 months and 12 months after treatment were significantly lower than those before treatment,and the differences were statistically significant（P<0.05）;There was no significant difference in visual analogue scale between the two groups after treatment（P>0.05）.There was no significant difference in the efficacy of Crawford between the two groups（P>0.05）.Conclusion:The study found that the choice of treatment methods for tendinous mallet finger deformity,external fixation conservative treatment and surgical treatment can achieve satisfactory results.Considering that some patients will have nail deformity,wound infection and other complications after surgical treatment,and the surgical treatment is traumatic,and the postoperative wound scar healing will affect the appearance of the fingers.After a comprehensive analysis of this study,it is suggested that for closed tendon mallet finger,conservative treatment with external fixation can be considered first.Conservative treatment is simpler and less invasive than surgical treatment.The results of this study have certain guiding significance for the selection of treatment methods for tendon mallet finger.In the case of no significant difference in clinical efficacy,choosing a more reasonable treatment method can effectively improve the satisfaction of patients while ensuring the clinical efficacy. |
PDF Full Text Request