Analysis Of The Clinical Efifcacy Of Two Surgical Treatments Of Reconstruction Of Extensor Apparatus Insertion

Objective: To evaluate the clinical effect of crisscross tunneling and double loopsuture and mitek mini bone anchors for reconstruction of extensor apparatus insertion.Methods: From March2011to March2013,25patients with extensor tendonavulsion were treated in our department by the same treatment group with differenttreatments. There were15males and10females with age of18～52years old, averageage was32.6years old, there were14cases with right hand injured and11cases withleft hand. Including2cases of thumb,4cases of the index finger,7cases of the middlefinger,4cases of the ring finger,8cases of the little finger. The treatment time afterinjure was between2hours to14days. One group of10cases was treated by themethod of crisscross tunneling and double loop suture, and the other group of15caseswas treated by mitek mini bone anchors. The duration of operation、length of hospitalstay and hospitalization costs were recorded. The patients were followed up aftersurgery. The activity of the distal interphalangeal joint was measured.(Use Darganscoring criteria to measure active and passive activity of the injured distalinterphalangeal joint), and compare the advantages、disadvantages and the curativeeffect of the two groups.Results: Record and compare the date of related imaging、activity of the injureddistal interphalangeal joint、the duration of operation、length of hospital stay、hospitalization costs and the postoperative complications. Through statistical analysis,the data was processed by SPSS17.0, paired t-test was used in measurement data. P＜0.05was considered as statistically significant differences. The length of operation timewithout the duration of anesthesia, which is about the processing time of reconstructionof extensor apparatus insertion, was recorded from the time the skin was incised to thetime the suture is completed. The average operation time of mitek mini bone anchorsgroup was about (30.4±4.28) minutes, the average operation time of crisscross tunneling and double loop suture group was about (58.6±2.58) minutes.22clientswere followed up after surgery，there were13cases in mitek mini bone anchors groupand9cases in the crisscross tunneling and double loop suture group. The postoperativefunctional recovery in the15cases of the mitek mini bone anchors group was recorded,11cases were excellent（73.33%）,3cases were good（20%）,1case was acceptable（6.67%）, no one was bad（0.00%）, The excellent and good rate was93.33%, averagepostoperative functional recovery was （42.4±5．86）°,2cases of the mitek mini boneanchors group were relapsed by the time of4months and6months after operation, therecurrence rate was13.33%. The postoperative functional recovery in the10cases of thecrisscross tunneling and double loop suture group was also recorded,8cases wereexcellent（80.00%）,1cases was good（10%）,1case was acceptable（10.00%） andno one was bad（0.00%）, The excellent and good rate was90.00%, averagepostoperative functional recovery was（41.8±3.64）°,1case of the crisscross tunnelingand double loop suture group was relapsed by the time of10months after treatment,the recurrence rate is10.00%. Relevant data shows that length of stay and postoperativefunctional recovery of the mitek mini bone anchors group had no significant differencecompared with the crisscross tunneling and double loop suture group, The averageoperation time of mitek mini bone anchors group was shorter than that of crisscrosstunneling and double loop suture group, but it cost higher..Conclusion: The injury of extensor terminal tendon is very common in the field ofhand surgery, simple avulsion extensor tendon injury is extremely the difficult case.Inappropriate treatment will significantly affect the function of fingers，Different typesof extensor tendon avulsion can be dealt with different treatments. For reconstruction ofextensor apparatus insertion, postoperative functional recovery and related imaging ofthe mitek mini bone anchors group had no significant difference compared with thecrisscross tunneling and double loop suture group. But mitek mini bone anchorstreatment option have some merits, such as simple surgical method, shorter surgery time.Though the treatment of crisscross tunneling and double loop suture is complicated, butits curative effect is also significant, so it is a novel, economical and practical method aswell. Use appropriate method of surgical treatment according to condition of thepatients and different types of extensor tendon injury, both methods could obtainsatisfactory curative effect.