Ⅱ～Ⅲ区指屈肌腱再断裂的早期修复  

Early repair of the re-ruptured digital flexor tenorrhaphy in zonesⅡandⅢ

作　　者：陈学明 许亚军 周晓 陈政 

机构地区：[1]无锡市第九人民医院手外科,江苏214000

出　　处：《中华手外科杂志》2016年第5期358-360,共3页Chinese Journal of Hand Surgery

摘　　要：目的总结Ⅱ-Ⅲ区指屈肌腱再次断裂后早期直接修复的临床结果。方法自2008年3月至2014年9月，我科收治了Ⅱ-Ⅲ区指屈肌腱术后再断裂患者17例（21指），男12例，女5例；Ⅱ区10例（10指），Ⅲ区7例（11指）；年龄18-42岁，平均31岁。断裂距再次手术时间为4-17d，平均8d。使用三个改良Kessler法修复指深屈肌腱，在Ⅲ区若有可能使用双改良Kessler法修复指浅屈肌腱。结果术后随访4-8个月，平均6个月。无肌腱再断裂。采用中华医学会手外科学会手指关节总活动度（TAM）功能评价标准评定指功能恢复：优良率85．7％（18／21指）。结论本研究显示早期修复再断裂的Ⅱ-Ⅲ区屈肌腱仍可获得满意的临床结果。Objective To evaluate Re outcomes of early direct repair of re-ruptured flexor digitortma tendons in ZoneⅡand Ⅲ. Methods We retrospectively studied 17 cases（21 digits） of re-rupture of primary flexor tendon repairs in Zones ⅡandⅢ treated between March 2008 and September 2014. Among them there were 12 males and 5 females with the mean age of 31 years （range, 18 to 42 years）. The rupture was in zoneⅢ in 10 cases and in zone Ⅲ in 7 cases. The interval between the re-operation and rupture was 4 to 17 days （average 8 days）. The flexor digitorum profundus tendon was repaired by triple modified Kessler＇s technique, and if possible, the flexor digitorum superficialis tendon in zone Ⅲ was repaired by double modified Kessler＇s suture. Results The follow-up period ranged from 4 to 8 months, with an average of 6 months. There was no re- rupture of the tendons. According to total active motion （TAM） classification of functional assessment criteria issued by the Chinese Hand Surgery Society, the final results were good to excellent in 85.7% of the digits. Conclusion Early repair of re-ruptured flexor tendons in zone Ⅱand Ⅲ could still lead to satisfactory results.

关 键 词：腱损伤 治疗结果 改良KESSLER法 早期修复 

分 类 号：R658.2[医药卫生—外科学]