Wide-awake技术在示指固有伸肌腱转位修复拇长伸肌腱术中的应用  

Application of wide-awake technique in repairing extentor policis longus tendon by transposition of extensor indicis digitoruem proper tendon

作　　者：张航 刘亚平 唐林俊 曾福俊 蒋国华 刘愉川 刁杰 ZHANG Hang;LIU Yaping;TANG Linjun(Department of Hand Surgery,Sichuan Xiandai Hospitol,Chengdu,Sichuan,610041,China)

机构地区：[1]四川现代医院手外科,四川成都610041

出　　处：《实用手外科杂志》2022年第2期242-244,共3页Journal of Practical Hand Surgery

基　　金：成都市科研课题(项目编号:2019060)。

摘　　要：目的介绍完全清醒的无止血带局部止血麻醉(Wide a wake local anesthesia no tourniquet)技术在示指固有伸肌腱转位修复拇长伸肌腱术的应用效果。方法2019年12月-2021年2月,在完全清醒无止血带局部麻醉下对12例拇长伸肌腱损伤进行示指固有伸肌腱转位手术,术后予石膏外固定3~4周,14 d拆线,术后3周白天拆除外固定,逐渐加大康复功能训练,夜间继续佩戴外固定1周。术后对患指功能恢复情况随访。结果术后12例拇指及手背伤口均一期愈合,全部获得5个月以上随访,平均12个月。术后拇指抬高丢失0~2.4 cm,平均1.8 cm;拇指屈曲丢失0~3.0 cm,平均1.6 cm;示指背伸丢失0°~15°,平均3°。按SEEM评分标准:优8例,良3例,可1例,优良率达91.7%。结论局麻清醒技术在示指固有伸肌腱转位修复拇长伸肌腱手术中应用安全有效,术中出血少,术后临床效果好,住院时间短,值得推广。Objective To introduce the clinical effect of wide awake local anesthesia no tourniquet in the repair of extensor hallucis longus tendon with transposition of extensor indicis proprius. Methods From December 2019 and Februrary 2021, 12 patients whose extensor pollicis longus tendon injury were treated with transposition of the extensor indicis proprius tendon using the wide awake approach.Postoperative immobilization for 3-4 weeks, sutures were removed at 14 days, 3 weeks after operation maintain the cast at night. The functional recovery of the affected finger was evaluated during follow-up after operation. Results All wounds healed well, 12 cases were followed-up for at least 5 months, mean followed-up 12 m. According to the SEEM scoring standard, 8 cases were excellent, 3 cases were good and 1 case was fair, with a good and excellent rate of 91.7%. Conclusion The wide awake local anesthesia no tourniquet in the repair of extensor hallucis longus tendon with transposition of extensor indicis proprius which is safe and effective, with less intraoperative bleeding, good postoperative clinical effect and short hospital stay, which is worth popularizing.

关 键 词：完全清醒 拇长伸肌腱 示指固有伸肌腱 肌腱转位 

分 类 号：R687.2[医药卫生—骨科学]