肌腱修复时机及腱鞘处理的实验研究  

FIexor tendon repair:timing of surgery and sheathManagement

作　　者：汤锦波[1] 侍德[1] 顾永强[1] 刘璠[1] 张其恭[1] 

机构地区：[1]南通医学院附属医院手外科

出　　处：《中华外科杂志》1995年第9期532-535,共4页Chinese Journal of Surgery

摘　　要：为探讨肌腱修复时机和腱鞘处理的作用，采用６０只来亨鸡双侧第三趾作实验，切断屈趾深肌腱后，根据伤后修复时间（立即、４、８、１４和２０天）分为Ａ、Ｂ、Ｃ和Ｅ五组。左侧足趾作腱鞘直接闭合，右侧作切除。修复后６周末检测腱滑动距离、足趾活动度、腱愈合、腱鞘形态。结果表明早期效果最佳，随伤后时间的延长肌腱功能和愈合变差，延迟较长时间导致明显功能受损。张力下关闭腱鞘在腱愈合时并不能保持其完整性，且不能提高腱功能。研究提示肌腱损伤后最佳修复时机是早期，延迟修复在伤后３周至１个月之内虽均能施行，但应尽可能在伤后较早数日内进行，延迟期内腱修复时不主张同时直接闭合修复腱鞘。AbstractEffect of timing of repair and management ofsheath on functions of injuried tendons was evaluated ina clinical relevant model using 60 white leghorn chick-ens, The flexor digitorum profundus(FDP)tendons ofthe long toes were cut and were repaired at 1,4,8,14and 2O days after injury.The sheath on the left footwas closed and that on the right excised.The tendonexcursion,toe motion morphology of the sheath andtendon healing were studied 6 weeks after tendon re-pair. Tendon funcitons were the best in primary re-pair,and they got worse as the delay became longer.Repair in the late stage produced significantly worsetendon functions. Sheath closure with remarkable ten-sion worsened tendon healing. We conclude that theoptimal timing for tendon repair is at the primarystage. Delayed tendon repair can be performed within 3weeks to one month after inury,but the repair ispreferably done in initial several days of delay,Directsheath closure is not advocated in tendon repair in thedelayed period.

关 键 词：腱鞘 修复术 处理 肌腱损伤 手屈肌腱 

分 类 号：R686.105[医药卫生—骨科学]