屈拇长肌腱Ⅱ区断裂的围手术期康复治疗  

Perioperative rehabilitative care for rupture of flexor tendon pollicis longus at ZoneⅡ

作　　者：林冷[1] 张振伟[1] 容春凤[1] 陈泽华[1] 张家俊[1] 魏水华[1] 钟宏丽[1] 廖明庭[1] 关助明[1] 

机构地区：[1]深圳市沙井人民医院手外科深圳市手外科治疗康复中心,518104

出　　处：《中华创伤骨科杂志》2006年第8期716-718,共3页Chinese Journal of Orthopaedic Trauma

摘　　要：目的以30例屈拇长肌腱Ⅱ区断裂一期治愈的忠者为例,阐述屈拇长肌腱损伤的围手术期康复治疗。方法2001年3月～2006年3月,对30例屈拇长肌腱Ⅱ区断裂患者采用双套圈交叉6股屈肌腱缝合法修复及石膏外固定。术后按照肌腱生物力学性能变化规律,在医师指导控制下进行功能训练。结果术后所有患者获得6～16周(平均8周)随访,按TAM评定标准评价疗效：优12例,良10例,中6例,差2例,优良率为73．3%。功能达到优良的22例患者术后16周能用患指完成持笔写字、扣纽扣及拿筷子等日常生活动作。无患者出现二次断裂。结论正确的术前诊断,术中无创伤和牢固的缝合技术,术后安全的外固定,按照肌腱愈合的生物力学改变特点,在医师指导控制下进行功能训练,是屈拇长肌腱Ⅱ区断裂一期治愈的关键。Objective To discuss perioperative rehabilitative care for flexor tendon injuries by examples of successful treatment of 30 cases of rupture of flexor tendon pollicis longus at Zone Ⅱ. Methods From March 2001 to March 2006, 30 cases of rupture of flexor tendon pollicis longus at Zone Ⅱ were treated in our department by suture with double loops and crossing six strands before external fixation. Patients were encouraged to do rehabilitation exercises for functional recovery under the guidance and supervision of orthopaedists. Results All the patients were followed up for 6 to 16 weeks （mean, 8 weeks）. According to TAM （Total Active Motion） criteria, 12 cases were rated as excellent, 10 cases as good, 6 cases as fair, and 2 cases as poor. The excellent to good rate was 73.3%. The 22 excellent and good cases could perform daily-life activities with affected fingers, such as writing, holding chopsticks and doing and undoing buttons. No patient experienced rerupture. Conclusion In perioperative rehabilitative care for rupture of flexor tendon pollicis longus at Zone Ⅱ, it is important to have correct diagnosis, noninvasive and secure suture, safe external fixation and functional exercises under the guidance of orthopaedists.

关 键 词：肌腱断裂 缝合技术 生物力学 功能训练 

分 类 号：R687.2[医药卫生—骨科学]