重建腱周组织一期修复指伸肌腱断裂的疗效分析  

Reconstruction of paratenon in one-stage repair of extensor tendon rupture:analysis of therapeutic effects

作　　者：王忠[1] 薛宏斌[1] 

机构地区：[1]延安大学附属医院手外科,陕西延安716000

出　　处：《西南国防医药》2011年第3期274-276,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨在指伸肌腱修复术中重建腱周组织减少肌腱粘连的方法。方法指伸肌腱损伤68例分为A、B两组(按配对设计原则),应用显微外科技术一期修复损伤。A组修复腱旁组织、深筋膜;B组不修复腱旁组织,仅修复深筋膜。术后早期进行保护性功能锻炼。术后随访3～12个月。结果术后6个月按美国手外科学会总主动活动度(TAM)系统评定方法评定疗效:A组优26例,良7例,可1例,优良率97.06%。B组优20例,良6例,可8例,优良率76.47%。两组优良率比较差异有统计学差异(P<0.05),A组效果优于B组。结论新鲜的指伸肌腱损伤,应用显微外科技术一期缝合腱旁组织,能更好地促进肌腱功能的恢复。Objective To investigate the therapeutic effects of paratendon reconstruction on the prevention of extensor tendon adhesion during the repair of extensor tendon.Methods 68 cases of extensor tendon injury were divided into group A and B based on the principle of matched-pair design,and 142 fingers underwent primary repair with microsurgical technique.Both the paratenon and deep fascia were sutured in group A,but only deep fascia were repaired in group B.Early postoperative synthetic rehabilitation training of the digits was carried out under protection.All patients were followed up for 3 to 12 months.Results The therapeutic effects were assessed according to total active movement（TAM）standard 6 months after operation.In group A,excellent results were obtained in 26 cases,good in 7 cases,fair in 1 case,and the fine rate was 97.06%.In group B,excellent results were obtained in 20 cases,good in 6 cases,fair in 8 cases,and the fine rate was 76.47%.The therapeutic effects between the two groups had significant differences（P0.05）.Conclusion The primary suture of paratenon in patients with flesh injured extensor tendon can promote the recovery of tendon function.Moreover,it can effectively prevent postoperative adhesion if combined with early systemic rehabilitation training.

关 键 词：指伸肌腱 腱周组织 修复 粘连 

分 类 号：R686[医药卫生—骨科学]