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目的 探讨克氏针弹性固定治疗Doyle Ⅰ、Ⅱ型锤状指的近期疗效.方法 2016年7月-2017年3月,收治Doyle Ⅰ、Ⅱ型锤状指18例.男12例,女6例;年龄16 ～ 61岁,平均45岁.损伤指别:示指2例,中指3例,环指10例,小指3例.受伤至手术时间2h～45d,中位时间5.5h.闭合性损伤8例,开放性损伤10例.单纯指伸肌腱断裂14例,伴撕脱性骨折的伸肌腱止点断裂4例.采用克氏针弹性跨关节固定远节指间关节(distal interphalangeal joints,DIPJ)于过伸位,6周后去除克氏针并进行功能锻炼.结果 手术时间34～53 min,平均38.9 min.患者均获随访,随访时间3～8个月,平均5个月.术后切口均Ⅰ期愈合;患指固定期间未发生克氏针松动、针眼处感染.患者锤状指畸形均得到纠正,术后6周拔除克氏针后,DIPJ被动活动无明显受限,主动屈曲角度为(75.83±11.15)°,与健侧对应指(85.28±6.06)°比较,差异有统计学意义(t=3.158,P=0.003).术后8个月,15例获随访患者患指DIPJ主动屈曲角度为(82.67±6.78)°,与健侧对应指(86.00±5.73)°比较,差异无统计学意义(t=1.454,P=0.157).术后6周拔除克氏针后,DIPJ主动屈曲时疼痛视觉模拟评分(VAS)为(1.78±0.88)分,被动屈曲至最大关节活动度时VAS评分为(3.06±1.06)分.术后3个月,根据总主动活动度(TAM)评定标准,获优10例、良5例、中2例、差1例,优良率为83.33％;患者满意度Likert评分为3～5分,平均4.2分.结论 克氏针弹性固定治疗Doyle Ⅰ、Ⅱ型锤状指,能有效修复指伸肌腱,纠正锤状指畸形,利于远期DIPJ屈伸功能恢复.“,”Objective To evaluate the short-term effectiveness of Kirschner wire (K-wire) elastic fixation in the treatment of Doyle type Ⅰ and Ⅱ mallet finger.Methods Between July 2016 and March 2017,18 patients with Doyle type Ⅰ and Ⅱ mallet finger were treated.There were 12 males and 6 males,with an average age of 45 years (range,16-61 years).The index finger was involved in 2 cases,the middle finger in 3 cases,the ring finger in 10 cases,and the little finger in 3 cases.The interval from injury to operation ranged from 2 hours to 45 days (median,5.5 hours).There were 8 patients of closed wound and 10 patients of open wound.Fourteen patients were simply extensor tendon rupture and 4 were extensor tendon rupture complicated with avulsion fracture.The distal interphalangeal joints (DIPJ) of injured fingers were elastically fixed with the K-wire at mild dorsal extend position.The K-wire was removed after 6 weeks,and the functional training started.Results The operation time was 34-53 minutes (mean,38.9 minutes).Patients were followed up 3-8 months (mean,5 months).All incisions healed primarily and no K-wire loosening or infection happened during the period of fixation.All mallet fingers were corrected.The range of motion (ROM) in terms of active flexion of injured DIPJ was (75.83±11.15)° at 6 weeks after operation,showing significant difference when compared with the normal DIPJ of contralateral finger [(85.28±6.06)°] (t=3.158,P=0.003).The ROM in terms of active flexion was (82.67±6.78)° in 15 patients who were followed up at 8 months after operation,showing no significant difference when compared with the normal DIPJof contralateral finger [(86.00±5.73)°] (t=1.454,P=0.157).After the removal of K-wire at 6 weeks,visual analogue scale (VAS) score of active flexion and of passive flexion to maximum angle were 1.78±0.88 and 3.06±1.06,respectively.According to the total active motion criteria,the effectiveness was rated as excellent in 10 cases,good in 5 cases,moderate in 2 cases,and poor in 1 case,and the excellent and good rate was 83.33％.The patients' satisfaction were accessed by Likert scale,which were 3-5 (mean,4.2).Conclusion K-wire elastic fixation in the treatment of Doyle type Ⅰ and Ⅱ mallet finger can repair the extensor effectively,correct the mallet finger deformity,and also be benefit for the flexion-extension function restoration of DIPJ.