Lysis little knife and small splint efficacy of treatment of active extensor lag

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To observe the mallet fingers active extensor lag after lysis with little knife and small splint treatment efficacy. [Methods] mallet fingers OK extensor tendon reconstruction after the final point of tendon only produce active extensor lag of cases 8 cases of 8 refers to the application of small needle-knife lysis, combined with a small splint after the short-term fixed, supplemented Beishen strength exercise. The clinical effect, analysis of the mechanism. [Results] The patients are given follow-up in March for more than an average of 16.5 weeks. Finger function with reference to international TAM System Assessment Method for the Evaluation, excellent in 2 cases, good in 6 cases, excellent rate of 100%. [Conclusion] The combination of little knife and tendons loosen splintage Beishen muscle exercise therapy supplemented with a finger mallet fingers extensor lag after operation simple curative effect, it is worth promoting.
[Keywords:] extensor lag; small needle-knife; hammer fingers; tendon loosening
Abstract: [Objective] To observe the cure effect of small needle  knife and splint on active extensor lag after hammer finger operation. [Method] For the 8 fingers of active extensor lag produced by reestablishment of tendon end point of extensor of hammer finger, make small needle  knife release, combined with post  operation small splint for short fixation, coordinated with back extensor exercise.Observe the clinical effect, analyse functional mechanism. [Result] All cases were followed up for over 3 m, 16.5 w in average . Appraise the fingers function under international TAM system; 2 were excellent, 6 good, the good and excellent rate was 100%. [Conclusion] The said method is simple for operation, with definite cure effect, worthy promotion.
Keywords:: extensor lag; small needle  knife; hammer finger; tendon release


Finger extensor tendon at the end of tendon device part of the damage caused to the initiative Beishen distal fingers can not form a mallet fingers. Traditional healing methods in dispute. Although many scholars tend to surgery-based treatment modalities, but it often happens that after a passive stretch out your fingers straight and full and active enough, that is, the phenomenon of active extensor lag [1], clinical management difficult. I Bureau since July 2006 to July 2008 using a small needle-knife with a small splint mallet fingers treated eight cases of postoperative extensor lag 8 refers to follow-up of 12 to 28 weeks, results were satisfactory.

1 Data and methods
1.1 The anatomical data for finger extensor tendon at the PIP joint device plane two lateral lines to the distal tendon, and gradually move closer to support or oppose midline, fuse to form the final tendon. Final tendon across the DIP joint, ends at the end of distal phalanx. According to Verdan sub-law, Jiang Zhi extensor tendon is divided into eight areas, distal interphalangeal joint and middle phalanx portion of E Ⅰ , E Ⅱ area. E Ⅰ extensor tendon in the area stretching device DIP joints two mechanisms: ① through the tendon to the proximal end of sliding rate of about 5mm. ② oblique retinaculum and stability through the DIP joint. [2]

1.2 General information refer to this group 8 cases of 8. 5 males and 3 females. Aged 16 years ~ 33 years. Are closed injury, a line ending point of extensor tendon reconstruction tendon end. Preoperative x-ray film was found two cases of avulsion of bone pieces. Do not refer to: two cases of index finger, middle finger in 1 case, ring finger in 3 cases, the little finger in 2 cases. Small needle-knife operation time until the point of restoration after 13 weeks ~ 18 weeks, an average of 14.5 weeks. Preoperative extensor lag 15 ~ 30 ° , an average of 20.25 ° .

1.3 a small surgical needle-knife
(1) fixed-point: In the distal dorsal stripes refer to the occasion of a little meat on both sides near the bottom of Chibai small needle-knife into the needle point.

(2) The operation carried out in reference to nerve block. Anesthesia achieved, risk refers to the roots of bleeding rubber band ligation. Zhu Huanzhe active Beishen suffering from that. First with the San Lengzhen one of the two fixed points into the needle become a lifelong affliction experience of the extensor tendon tendon tension, with inclined blade knife in the extensor tendon and the cortical bone beneath the peel adhesion between the organizations, the proximal end to near the vicinity of PIP joints, far end-to-base distal phalanx, and then stripped the surface of the extensor tendon adhesion between the tendon and skin organization, proximal PIP joints as close as possible, the remote until the nail root. Contralateral needle point with the law. To the extensor tendon on the bottom of no significant adhesion organization, operation completed.

(3), put rubber band tourniquet, clenched patients suffering from that area to completely stop bleeding hemostasis 15min. Sterile dressing bandage, a small plastic splint DIP, PIP joints in extension position. (4) 3 weeks after functional exercise. Night is still a small splint will be applied DIP joints fixed straight position during the day and removed.

2 Results
8 cases in this group are given in March for more than 8 refers to follow-up, an average of 16.5 weeks. Finger function reference to the International Institute of Hand Surgery recommended TAM (total active montion) System Assessment Method for Evaluation of [3], excellent: far interphalangeal joint active range of normal; Liang: TAM

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