摘要目的:Ⅴ型指深屈肌腱撕脱性损伤相对罕见，损伤复杂，治疗困难。本研究对微型接骨板及克氏针内固定治疗的临床疗效进行评估。方法:自2018年1月至2022年10月，17例患者因Ⅴ型指深屈肌腱撕脱性损伤于我科接受手术治疗，Ⅴa型8例，Ⅴb型9例。采用切开复位微型接骨板和克氏针固定方式治疗。术中以远指间关节(distal interphalangeal joint，DIPJ)为中心设计掌侧Brunner切口，显露骨折端并复位，先以1枚直径1.0 mm克氏针纵行固定远、近端骨折块，并同时固定DIP关节，随后以1.7 mm的4孔T型微型接骨板固定指深屈肌腱附着的掌侧骨折块及远、近端骨折块。术后行X线片检查，骨折愈合后拔除克氏针，开始进行DIP关节非持重功能锻炼。结果:17例患者平均于损伤时间后6.1 d(2～11 d)接受手术治疗，术后平均随访时间为23.8个月(13～44个月)，骨折愈合时间6～7周，愈合率100%。末次随访时，患指疼痛VAS评分均为0分，无指甲畸形和X线片骨关节炎表现，近指间关节(proximal interphalangealjoint，PIPJ)活动度较健侧一致。Ⅴa型DIP关节活动度较健侧平均减少11.3°(5°～20°)，Ⅴb型DIP关节活动度平均较健侧减少10.6°(0～20°)。结论:Ⅴ型指深屈肌腱撕脱性损伤采用切开复位微型接骨板结合克氏针固定治疗，骨折复位和固定强度可靠，能够获得良好的骨折愈合率和术后关节活动度。

abstractsObjective:To evaluate the clinical efficacy of miniplate and Kirschner wire internal fixation for the treatment of type Ⅴ flexor digitorum profundus(FDP) avulsion which was relatively rare, complex, and difficult to treat.Methods:From January 2018 to October 2022, 17 patients underwent surgical treatment in our department due to type Ⅴ FDP avulsion injury, including 8 cases of type Ⅴa and 9 cases of type Ⅴb. Treatment was performed using an open reduction miniplate and Kirschner wire internal fixation. During the operation, a palm side Brunner incision was designed centered around the distal interphalangeal joint (DIPJ) to expose the fracture end and reduce it. First, a 1.0 mm diameter Kirschner wire was used to longitudinally fix the distal and proximal fracture blocks, while also fixing the DIPJ. Then, a 1.7 mm 4-hole T-shaped miniplate was used to fix the palmar fracture block and the distal and proximal fracture blocks attached to FDP. Postoperative X-ray examination was performed. After the fracture healed, the Kirschner wire was removed and non weight-bearing functional exercise of the DIPJ began.Results:Seventeen patients received surgical treatment on average 6.1 days (2 to 11 days) after the injury time. The average follow-up time after surgery was 23.8 months (13 to 44 months), and the fracture healing time was 6 to 7 weeks, with a healing rate of 100%. At the last follow-up, the VAS for finger pain was 0, and there were no nail deformities or X-ray manifestations of osteoarthritis. The range of motion of the proximal interphalangeal joint (PIPJ) was consistent with that of the healthy side. The average range of motion of type Ⅴa DIPJ decreased by 11.3 ° (5 ° to 20 °) compared to the healthy side, while the average range of motion of type Ⅴb DIPJ decreased by 10.6 ° (0 to 20 °) compared to the healthy side.Conclusion:The treatment of type ⅤFDP avulsion injury using open reduction miniplate combined with Kirschner wire fixation is reliable in fracture reduction and fixation strength, and can achieve good fracture healing rate and postoperative joint mobility.