骨形态发生蛋白结合自体腱重建开放性指伸肌腱止点断裂的临床观察  

Clinical observation of BMP combined with autogenous tendon in the reconstruction of open extensor digitorum tendon rupture

作　　者：刘和风[1] 李业海[1] 唐浩然[1] 李晓天[1] 王春[1] LIU Hefeng;LI Yehai;TANG Haoran;LI Xiaotian;WANG Chun(Chaohu Hospital of Anhui Medical University,Chaohu,Anhui 238000,China)

机构地区：[1]安徽医科大学附属巢湖医院,安徽巢湖238000

出　　处：《安徽医药》2018年第4期715-717,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨骨形态发生蛋白(BMP)与自体掌长肌腱移植结合骨隧道重建开放性指伸肌腱止点断裂,为临床治疗伸肌腱止点断裂提供一种安全有效的选择。方法自2013年2月至2016年3月共收治手部开放性指伸肌腱止点断裂23例患者,取5 cm自体掌长肌腱组织,腱粗2 mm。用2.0 mm钻头于末节指骨近端钻一横孔,再用3.0 mm钻头于指骨背侧钻一单皮质垂直孔,肌腱穿过横孔并从垂直孔抽出形成3束,与伸肌腱近侧断端吻合,骨道处置入BMP 2 mg,指伸位铝板外固定制动4周后去除铝板康复锻炼。结果术后随访6~12个月,平均8个月,23例患者中21例患者获得术后随访,按手指总主动活动度(TAM)评定法评定:优13例,良6例,可2例,优良率为90%。结论该术式对伸肌腱止点行解剖重建,达到腱骨愈合,疗效满意,为伸肌腱止点重建提供了一种可靠的选择,值得临床推广应用。Objective To explore the reconstruction of open extensor digitorum tendons rupture with bone morphogenetic protein(BMP)and autogenous palmaris long tendon graft combined with bone tunnel,and to provide a safe and effective choice for the treatment of extensor tendon rupture.Methods5cm autologous palmaris longus tendon tissue,tendon coarse2mm were selected,with the2.0mm bit in phalangette proximal to drill a horizontal hole,and then the3.0mm bit on the back side of a single vertical hole drilling and cortex,tendon through cross hole and from vertical hole out to form the3beam,and the extensor tendon proximal stump anastomosis.The bone tunnel was disposed into BMP2mg,extensor an aluminium plate brake to aluminum rehabilitation exercise after4weeks.Results The patients were followed up for6-12months,with an average of8months.In23patients,21patients were followed up.According to the index of total active range of motion(TAM)evaluation,there were13cases excellent,6cases good,2cases fair.The excellent and good rate was90%.Conclusions This method can be used for anatomical reconstruction of extensor tendon insertion site and achieve satisfactory tendon healing.It provides a reliable choice for the reconstruction of extensor tendon insertion,which is worthy clinical application.

关 键 词：自体肌腱 伸指肌腱 止点重建 骨隧道 骨形态发生蛋白 

分 类 号：R687.2[医药卫生—骨科学]