The efficacy of modified Ishiguro method in the treatment of mallet finger

Abstract

Objective: To investigate the short- and medium-term clinical efficacy of the modified Ishiguro method and Ishiguromethod for the treatment of mallet finger. Methods: A total of 65 patients with avulsion fracture of extensor tendon were selected from the Affiliated Hospital of Southwest Medical University from September 2018 to March 2021. They were treated with the traditional Ishiguro method and the modified Ishiguro method of our hospital. There were 31 patients in the Ishiguro method group, 17 males and 14 females, 25.6 ± 4.3 years old. The operation time caused by injury was 3.1 ± 0.6 days. According to Wehbe and schneifer's classification, there were 9 cases of type II, 15 cases of type III and 7 cases of type IV; There were 34 patients in the modified group, including 21 males and 13 females, 27.5 ± 5.6 years old. The operation time caused by injury was 3.4 ± 0.5 days, including 12 patients of type II, 14 patients of type III and 8 patients of type IV. In both groups, the Kirschner wire was removed after X-ray reexamination 4-6 weeks after operation, and the curative effect was evaluated by Crawford standard and VAS score. Results: All cases were followed up for 14.5 ± 2.1 months. There was a significant difference in VAS score of finger flexion between the two groups 1 month after operation (t=-4.349, P<0.001), and there was no significant difference in VAS score between the two groups 3 and 6 months after operation. The excellent and good rate of Crawford score in Shihei group was 19.4%, while that in improved group was 85.0% (Z=-4.349, P<0.001). At the last follow-up, the distal finger flexion was 64.28 ± 13.75 ° in the Ishigurogroup while 82.72 ± 8.59 ° in the modified group (t=-6.557, P<0.001). The follow-up of the improved group showed that the fractures healed well, the distal interphalangeal joint activities of the patients were good, and there were no nail deformities, needle infection, interphalangeal joint deformities,interphalan interphalangeal arthritis, interphalangeal joint stiffness and other complications. The follow-up X-ray examination showed that all patients were primary healed. Conclusion: The application of the modified Ishiguro method for the treatment of distal interphalangeal joint extensor tendon avulsion fracture was satisfactory, with reliable fixation, good fracture healing, satisfactory extensor tendon stop reconstruction, and good functional recovery of the affected finger.