肌腱环扎缝合法修复手二区屈肌腱损伤  

Loop-lock Tenorrhaphy to Repair Zone II Flexor Tendon

作　　者：崔勇[1] 金寿哲 刘钦毅[2] 宫文武[1] 崔勇男[1] 

机构地区：[1]吉林省珲春市医院骨科,133300 [2]吉林大学第二临床学院骨科

出　　处：《骨与关节损伤杂志》2003年第8期534-535,共2页The Journal of Bone and Joint Injury

摘　　要：目的 观察肌腱环扎缝合法修复手二区屈肌腱损伤的疗效。方法 在清晰术野下,暴露肌腱两断端,用0/4尼龙线,距肌腱断端1 cm处横行穿针,在距横穿线靠断端方向1 mm处以肌腱宽度和厚度的1/3环绕出针后把针靠断端方向套入缝线内,在附近靠断端方向1 mm处刺入肌腱,与肌腱纵轴平行自断面穿出,相对侧同法缝合,另一断端也同法缝合,然后相对应缝线拉拢打结。两断端用0/9无损伤缝合线间断或连续缝合,彻底止血后修复腱鞘及闭合创口,术后背侧石膏托制动3周,进行有计划的功能练习。结果 本组18例26指,随访2～16个月,按TAM评定标准18例26指中优23指、良3指,疗效满意。结论 肌腱环扎缝合法修复手二区屈肌腱损伤,手术操作简便符合早期功能练习的要求,值得推广应用。Objective To observe the effect of a new tenorrhaphy, loop-lock tendon suture, which were used in repair of Zone II flexor tendon injuries. Methods Twenty-six tendons of 18 patients were repaired by the loop-lock tenorrhaphy. Separate sutures were introduced in each tendon end at distance of 1cm. Firstly, the double armed needle (0/4 nylon suture) passed across the tendon transversely. At each side, the needle passed medially through the tendon, so that approximately 1/3 of width and thickness of tendon was then grasped at the distance 1 mm nearer to the cut surface. Then the needle passed through the loop, and locked by a knot. The suture then entered the tendon at the distance 1-2 mm nearer to the cut surface, and passed down and to the tendon end. Following placement of similar suture in oppsite side and opposite end, two tendon ends could be brought together, and repair was tidied up by small circumferential suture with 0/9 thread. The tendon theath was finally repaired. The wrist and hand were held in a posterior splint for 3 weeks. The wrist, metacarpophalangeal and interphalangeal joints were flexed to 30°, 45°, and 30° respectively. Controlled mobilization of repaired flexor tendon was carried out 24 hours after the procedure. Results The patients were followed up after 2- 16 months. According to TAM estimating standard, 23 tendons were excellent, and 3 were good, Their effect is satisfactory. Conclusion Loop-lock tenorrhaphy is a easy and safe method to repair Zone II flexor tendon.

关 键 词：肌腱环扎缝合法 修复 手二区屈肌腱损伤 疗效观察 

分 类 号：R658.2[医药卫生—外科学] R686.1[医药卫生—临床医学]