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目的探讨改良第二跖趾关节修复掌指关节背侧缺损的应用解剖。方法选取2006年12月到2014年12月收治的掌指关节背侧缺损患者共68例,将患者随机分为两组,每组34例,A组行改良第二跖趾关节修复治疗,B组行拇短伸肌半腱移位修复,对比两组患者随访痊愈率和并发症等现象。结果术后3个月,A组优9例,良24例,差1例,优良率为91.18%;B组优8例,良18例,差8例,优秀率为76.47%;组间比较差异有统计学意义(P<0.05)。A组患者的手术时间、开始活动时间、住院时间明显短于B组(P<0.05),术中出血量明显低于B组(P<0.05),ASIA评分明显高于B组(P<0.05)。结论改良第二跖趾关节修复治疗掌指关节背侧缺损能取得满意的效果,能有效提高痊愈率,缩短患者康复时间,使患者早日恢复活动能力,具有积极的临床推广意义。
Objective To explore the anatomic anatomy of modified second metatarsophalangeal joint for the repair of dorsal flanks of metacarpophalangeal joints. Methods A total of 68 patients with dorsal metacarpophalangeal joint defects were selected from December 2006 to December 2014. The patients were randomly divided into two groups (34 in each group). Group A received modified second metatarsophalangeal joint repair and B Group of thumb extensor semi-tendon shift repair, compared two groups of patients followed-up cure rate and complications and so on. Results In the 3 months after operation, the results were excellent in 9 cases, good in 24 cases and poor in 1 case, the excellent and good rates were 91.18% in group A, 8 cases in group B, 18 cases in good and 8 cases in poor. The excellent rate was 76.47% The difference was statistically significant (P <0.05). The operation time, initial activity time and length of hospital stay in group A were significantly shorter than those in group B (P <0.05). The blood loss in group A was significantly lower than that in group B (P <0.05), and the ASIA score was significantly higher than that in group B ). Conclusion The improved second metatarsophalangeal joint repair can achieve satisfactory results in the dorsal flank defect of the metacarpophalangeal joint, which can effectively improve the cure rate, shorten the recovery time of patients and enable the patients to resume their activities as soon as possible, which has a positive clinical significance.