目的介绍一种弹性外固定架在儿童锤状指治疗中的应用及体会。方法2003年2月至2008年9月，我们在对31例（31指）儿童锤状指患儿的治疗中，首先用直径0．8～1．0mm的克氏针2根，制成具有弹性的手指外固定架，将伤指固定于近侧指问关节屈...目的介绍一种弹性外固定架在儿童锤状指治疗中的应用及体会。方法2003年2月至2008年9月，我们在对31例（31指）儿童锤状指患儿的治疗中，首先用直径0．8～1．0mm的克氏针2根，制成具有弹性的手指外固定架，将伤指固定于近侧指问关节屈曲、远侧指间关节伸直的体位，然后修复伸指肌腱或固定撕脱的骨块，术后4周进行患指主动屈曲功能锻炼，6周后去除外固定架。结果本组患儿31例31指均获随访，随访时间5个月至4．5年。指伸肌腱及骨折均愈合良好，锤状指畸形完全矫正，伤指外形无肿胀，关节活动正常，骨骼生长未受影响，不影响学习及生活。根据TAM（total active movement，TAM）系统评定方法：优25例，良6例，可、差均为0例，优良率100％。结论弹性外固定架作为儿童锤状指治疗的外固定措施是一种操作简单、损伤轻微、固定可靠、治疗有效的方法，临床可以推广。展开更多
Background：Hand injuries are very common in sports,such as skiing and ball sports.One of the major reasons causing hand and finger deformity is due to ligament and tendon injury.The aim of this study was to investiga...Background：Hand injuries are very common in sports,such as skiing and ball sports.One of the major reasons causing hand and finger deformity is due to ligament and tendon injury.The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging （MRI） can demonstrate the complex anatomy of the fingers and thumb,especially the tendons and ligaments,and provide the accurate diagnosis of clinically important fingers and thumbs deformity due to ligamentous and tendinous injuries during sport activities.Methods：Sixteen fresh un-embalmed cadaveric hands were harvested from eight cadavers.A total of 20 healthy volunteers＇ hands and 44 patients with fingers or thumb deformity due to sports-related injuries were included in this study.All subjects had MR examination with T1-weighted images and proton density-weighted imaging with fat suppression （PD FS） in axial,coronal,and sagittal plane,respectively.Subsequently,all 16 cadaveric hands were sliced into 2-mm thick slab with a band saw （six in coronal plane,six in sagittal plane,and four in axial plane）.The correlation of anatomic sections and the MRI characteristics of tendons of fingers and the ulnar collateral ligament （UCL） at the metacarpal phalangeal joint （MCPJ） of thumb between 20 healthy volunteers and 44 patients （confirmed by surgery） were analyzed.Results：The normal ligaments and tendons in 16 cadaveric hands and 20 volunteers＇ hands showed uniform low-signal intensity on all the sequences of the MRI.Among 44 patients with tendinous and ligamentous injuries in the fingers or thumb,12 cases with UCL injury at MCPJ of the thumb （Stener lesion =8 and non-Stener lesion=4）,6 cases with the central slip injury,12 cases with terminal tendon injury,and 14 cases with flexor digitorum profundus injury.The ligaments and tendons disruption manifested as increased signal intensity and poor definition,discontinuity,and heterogeneous signal intensity of the involved ligaments and tendons.Conclusions：Sports inju展开更多
文摘目的介绍一种弹性外固定架在儿童锤状指治疗中的应用及体会。方法2003年2月至2008年9月，我们在对31例（31指）儿童锤状指患儿的治疗中，首先用直径0．8～1．0mm的克氏针2根，制成具有弹性的手指外固定架，将伤指固定于近侧指问关节屈曲、远侧指间关节伸直的体位，然后修复伸指肌腱或固定撕脱的骨块，术后4周进行患指主动屈曲功能锻炼，6周后去除外固定架。结果本组患儿31例31指均获随访，随访时间5个月至4．5年。指伸肌腱及骨折均愈合良好，锤状指畸形完全矫正，伤指外形无肿胀，关节活动正常，骨骼生长未受影响，不影响学习及生活。根据TAM（total active movement，TAM）系统评定方法：优25例，良6例，可、差均为0例，优良率100％。结论弹性外固定架作为儿童锤状指治疗的外固定措施是一种操作简单、损伤轻微、固定可靠、治疗有效的方法，临床可以推广。
基金This study was supported by grants from the National Natural Science Foundation of China （No. 81371515, No. 81771809）, the Beijing Natural Science Foundation of China （No. 7142075）, the Capital Medical Development and Scientific Research Fund of China （No. 2016-2-1122）.
文摘Background：Hand injuries are very common in sports,such as skiing and ball sports.One of the major reasons causing hand and finger deformity is due to ligament and tendon injury.The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging （MRI） can demonstrate the complex anatomy of the fingers and thumb,especially the tendons and ligaments,and provide the accurate diagnosis of clinically important fingers and thumbs deformity due to ligamentous and tendinous injuries during sport activities.Methods：Sixteen fresh un-embalmed cadaveric hands were harvested from eight cadavers.A total of 20 healthy volunteers＇ hands and 44 patients with fingers or thumb deformity due to sports-related injuries were included in this study.All subjects had MR examination with T1-weighted images and proton density-weighted imaging with fat suppression （PD FS） in axial,coronal,and sagittal plane,respectively.Subsequently,all 16 cadaveric hands were sliced into 2-mm thick slab with a band saw （six in coronal plane,six in sagittal plane,and four in axial plane）.The correlation of anatomic sections and the MRI characteristics of tendons of fingers and the ulnar collateral ligament （UCL） at the metacarpal phalangeal joint （MCPJ） of thumb between 20 healthy volunteers and 44 patients （confirmed by surgery） were analyzed.Results：The normal ligaments and tendons in 16 cadaveric hands and 20 volunteers＇ hands showed uniform low-signal intensity on all the sequences of the MRI.Among 44 patients with tendinous and ligamentous injuries in the fingers or thumb,12 cases with UCL injury at MCPJ of the thumb （Stener lesion =8 and non-Stener lesion=4）,6 cases with the central slip injury,12 cases with terminal tendon injury,and 14 cases with flexor digitorum profundus injury.The ligaments and tendons disruption manifested as increased signal intensity and poor definition,discontinuity,and heterogeneous signal intensity of the involved ligaments and tendons.Conclusions：Sports inju
