可吸收线治疗骨性锤状指远指间关节固定针位置的解剖研究

谭周勇,  傅小宽,  谭亮,  刘英男,  魏瑞鸿,  方锡池,  庄永青

中国临床解剖学杂志 ›› 2020, Vol. 38 ›› Issue (4) : 376-380.

中国临床解剖学杂志 ›› 2020, Vol. 38 ›› Issue (4) : 376-380. DOI: 10.13418/j.issn.1001-165x.2020.04.003
应用解剖

可吸收线治疗骨性锤状指远指间关节固定针位置的解剖研究

  • 谭周勇, 傅小宽, 谭亮, 刘英男, 魏瑞鸿, 方锡池, 庄永青 
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Anatomical Study of fixing distal interphalangeal joint on treating bony mallet finger by absorption suture tying avulsion fracture fragment

  • TAN Zhou-yong, FU Xiao-kuan, TAN Liang, LIU Ying-nan, WEI Rui-hong, FANG Xi-chi, ZHUANG Yong-qing 
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摘要

目的 通过测量末节手指的体表标记线与克氏针进针点的关系,为可吸收线捆扎固定撕脱骨块治疗骨性锤状指的远指间关节固定针进针点及角度、缝合线导引孔的位置提供解剖学依据。  方法 在16侧新鲜成人上肢标本的拇指、示指、中指、环指、小指各16根上模拟远侧指间关节的固定针(克氏针)固定,并测量进针点及进针角度。  结果 远侧指间关节伸0°位时,固定针宜从指体侧方进针,固定远侧指间关节的最佳进针点位于末节指骨基底部与指骨干交界处,进针角度与末节指骨中轴线成30°夹角,进针点到指远侧纹平面距离分别为:拇指13 mm、示指12 mm、中指13 mm、环指12 mm、小指11 mm。可吸收线导引孔最佳进针点在肌腱止点远端的指骨侧中线体表投影线上。  结论 固定针进针点以及导引孔位于上述各手指的位置时,既固定牢固、不损伤甲基质,也不影响撕脱骨片的复位。

Abstract

Objective To investigate the relationship between body surface marking line of distal finger and Kirschner's needle insertion point, and to provide anatomical basis for treating bony mallet finger by absorbable suture tying avulsion fracture fragment, including the entry point and angle of the needle for fixing distal interphalangeal joint, the position of the absorbable suture’s guiding hole. Methods 16 fresh adult upper limb specimens were randomly selected, including 16 thumbs, 16 index fingers, 16 middle fingers, 16 ring fingers and 16 little fingers. The entry point and angle of Kirschner wire for fixing distal interphalangeal joint were measured. Bone mallet finger model group was built according to the angle between bone avulsion fracture line and the axis of the distal phalanx. Results When the distal interphalangeal joint extended at 0°, the fixation needle should be inserted from the side of the finger body. The optimal insertion point for the fixation of the distal interphalangeal joint was located at the junction of the base of the distal phalanx and the finger backbone. The included angle between insertion angle and the axis of the distal phalanx was 30°, and the distance from the insertion point to the plane of the distal phalanx of the finger was 13mm of the thumb, 12mm of the index finger, 13mm of the middle finger, 12mm of the ring finger, and 11mm of the little finger, respectively. The best insertion point of the absorbable guide hole was on the surface projection line of the midline lateral phalanx of the tendon insertion. Conclusions When the insertion point of the fixation needle and the guide hole are located in the positions of the above-mentioned fingers, the insertion point and the guide hole are fixed firmly, which will not damage the methyl matrix and will not affect the restoration of the avulsed bone slice.

关键词

可吸收线 /  骨性锤状指 /  指 /  解剖研究

Key words

Absorbable suture /  Bony mallet finger /   Finger /  Anatomical study

引用本文

导出引用
谭周勇,  傅小宽,  谭亮,  刘英男,  魏瑞鸿,  方锡池,  庄永青. 可吸收线治疗骨性锤状指远指间关节固定针位置的解剖研究[J]. 中国临床解剖学杂志. 2020, 38(4): 376-380 https://doi.org/10.13418/j.issn.1001-165x.2020.04.003
TAN Zhou-yong, FU Xiao-kuan, TAN Liang, LIU Ying-nan, WEI Rui-hong, FANG Xi-chi, ZHUANG Yong-qing. Anatomical Study of fixing distal interphalangeal joint on treating bony mallet finger by absorption suture tying avulsion fracture fragment[J]. Chinese Journal of Clinical Anatomy. 2020, 38(4): 376-380 https://doi.org/10.13418/j.issn.1001-165x.2020.04.003
中图分类号: R323.71    R683   

参考文献

[1]  Tung K Y, Tsai M F, Chang S H, et al. Modified tenodesis method for treatment of mallet fractures[J]. Ann Plast Surg, 2012, 69(6):622-626.
[2]  周广良, 蒋国栋, 邹国平, 等. 改良克氏针张力加压牵引治疗骨性锤状指[J].中华手外科杂志, 2015, 31(1):6-8.
[3]  江波, 于培吉, 赵家举, 等. 克氏针与抽出钢丝内固定治疗骨性锤状指的比较研究[J].中华手外科杂志, 2015, 31(1):3-5. 
[4]  杨凯,张全荣, 陆征峰. 改良三针法经骨折块固定治疗骨性锤状指[J].实用手外科杂志, 2018, 32(4):78-79.
[5]  聂晶晶,钟书强, 于景臣, 等 克氏针加压能内固定技术治疗外伤后骨性锤状指的临床研究[J]. 齐齐哈尔医学院学报, 2018, 39(7):773-775.
[6]  顾玉东,王澍寰,侍德. 手外科手术学[M]. 上海:上海医科大学出版社,1999. 434-436.
[7]  程国良,潘达德. 手指再植与再造[M]. 北京:人民卫生出版社,1996.28.
[8]  Jams. The hand[M]. 沈阳:辽宁科技出版社, 2003. 9.
[9]  管英杰. 末节指骨基底背侧撕脱性骨折钢丝内固定的新经验[J]. 实用手外科杂志, 2001, 15(4):246.

基金

深圳市医疗卫生三名工程项目(SZSM201512032)

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