指深屈肌腱经骨隧道重建Ⅰ区伸肌腱止点的临床应用  

Clinical application of zone Ⅰ extensor tendon reconstruction on its insertion using the section of flexor digitorum profundus via bone tunnel

作　　者：黎飞猛[1] 谢鼎良[2] 孙鸿涛[1] 齐勇[1] 林周胜[1] 王韵廷 

机构地区：[1]广东省第二人民医院,广州510317 [2]广州中医药大学祈福医院,广州511495

出　　处：《创伤外科杂志》2017年第4期276-278,共3页Journal of Traumatic Surgery

基　　金：广东省"十一五"医学重点专科"创伤显微外科"项目(粤卫[2008]50号)

摘　　要：目的介绍一种Ⅰ区指伸肌腱止点重建的方法。方法对20例伸肌腱止点撕脱、断裂伤患者进行止点重建的手术治疗,其中男性12例,女性8例;年龄22~46岁,平均32岁。左手7例,右手13例;示指9例,环指8例,小指3例;撞击伤12例,割裂伤5例,压砸伤3例。受伤至手术时间2h^35d,平均8.7d。采用克氏针固定远侧指间关节,转移部分指深屈肌腱经末节指骨骨隧道到背侧伸肌腱止点上缘穿出,与伸肌腱近端编织缝合。结果术后随访6个月~1年,无一例发生肌腱再次断裂,按手指总主动活动度(TAM)评定法评定:优13例,良6例,可1例。结论采用指深屈肌腱经骨隧道重建Ⅰ区伸肌腱止点,疗效满意。Objective To introduce a method of zoneⅠextensor tendon reconstruction on its insertion.Methods Twenty cases of extensor tendon insertion avulsion or rupture patients were included in this study.Among them 12 were males and 8 were females with an average of 32（22-46） years.Seven cases were on the left hand and 13 cases were on the right hand,with 9 on the index finger,8 on the ring finger and 3 on the little finger.Twelve were injured from crush,5 were from cuts and 3 were from falling objects.They were operated 2h-35d（8.7d on average） after injury.They were treated by reconstructing the insertion surgically by Kirschner wire fixed the distal interphalangeal joint,and then transferred part of flexor digitorum profundus piercing to dorsal of the insertion of extensor tendon through bone tunnel of distal phalanx,finally braided suture with distal stump of extensor tendon.Results All the patients were followed up for 6 months to 1 year.No tendon rupture happened again.According to TAM scoring classification,result was excellent in 13 cases,good in 6 cases,and fair in 1 case.Conclusion The method of extensor tendon reconstruction using the section of flexor digitorum profundus piercing to dorsal of the insertion of extensor tendon through bone tunnel can achieve satisfactory outcomes.

关 键 词：指伸肌腱 止点重建 屈肌腱 骨隧道 

分 类 号：R687.2[医药卫生—骨科学]