Ⅱ区屈肌腱断裂的临床分型和治疗  

The Clinical Typing and Treatment of Flexor Tendon Rupture in Zone Ⅱ

作　　者：方均强[1] 张振伟[1] 廖坚文[1] 

机构地区：[1]广东省深圳市沙井人民医院手外科,广东深圳518104

出　　处：《医学临床研究》2005年第12期1660-1661,1664,共3页Journal of Clinical Research

基　　金：深圳市宝安区科学技术局科技计划项目(项目编号2001-095)

摘　　要：[目的]介绍Ⅱ区屈肌腱断裂的临床分型和治疗方法.[方法]按腱缝合后鞘内置入法治疗Ⅱ区屈肌腱损伤53例63指:屈指型45例54指,在肌腱远断端以远0.5 cm另作腱鞘切口,缝合肌腱;伸直形8例9指经原腱鞘切口缝合肌腱.缝合肌腱均用Tsuge法,术后使吻合口于健康腱鞘内并注射透明质酸钠0.5～1.0 ml.[结果]术后随访5个月至1年7个月,按TAM评定标准评定疗效,屈指型54指,优38指,良10指,中4指,差2指,优良率88﹒89%.伸直型9指,优5指,良2指,中1指,差1指,优良率77.78%,总优良率87.3%.[结论]该术式对屈肌腱损伤疗效满意,可能与肌腱吻合口被健康腱鞘包容和透明质酸钠促进肌腱愈合,防止或减轻术后粘连的作用有关.[Objective]To introduce the clinical typing and treatment of flexor tendon rupture in zone Ⅱ. [Methods]Flexor tendon injuries were divided into the extension type and the flexion type. The flexion tendons of the extension type were repaired via the priginal cut on the sheath, the suture site of the tendon slided into the proximal intact part of the sheath 0.5 cm distal to distal tendon stump,and the tendon was repaired via the incision, The suture site was then placed in the intact sheath canal between the two cuts, 0.5-1.0 ml sodium hyaluronidase（SHP） was injected into the tendon sheath in the operation of primary tendon repair of 63 flexor tendon in 53 cases. Among them 8 were extension type and 45 were flexion type. [Results]Sixty-three tendons of 53 cases were followed up for an average of 10 months, according to TAM standard, the excellent and good rate was 87.3%. [Conclusion]Intrasheath embedding of the suture site is an optimal surgical procedure in flexor tendon in zone Ⅱ , SHP could effectively promote tendon healing and prevent or reduce tendon adhesion.

关 键 词：腱损伤/外科学 

分 类 号：R687.2[医药卫生—骨科学]