文章简介

出版社:Indian J Plast Surg.

作   者:Abdul-Kader MH, Amin MA

编   号:doi: 10.4103/0970-0358.63944.

年   份:2010    点击量:422

文章摘要

We report the results of staged flexor tendon reconstruction in 12 patients (12 fingers) with neglected or failed primary repair of flexor tendon injuries in zone II. Injuries involved both flexor digitorum profundus (FDP) and flexor digitorum sublimis (FDS), with poor prognosis (Boyes grades II-IV). The procedure included placing a silicone rod and creating a loop between the FDP and FDS in the first stage and reflecting the latter as a pedicled graft through the pseudosheath created around the silicone rod in the second stage. At a mean follow-up of 18 months (range 12-30 months), results were assessed by clinical examination and questionnaire. The mean total active motion of these fingers was 188°. The mean power grip was 80.0% and pinch grip was 76% of the contralateral hand. The rate of excellent and good results was 75% according to the Buck-Gramcko scale. These results were better than the subjective scores given by the patients. Complications included postoperative hematoma in two, infection in one, silicone synovitis in one (after stage I) and three flexion contractures after stage II. This study confirmed the usefulness of two-stage flexor tendon reconstruction using the combined technique as a salvage procedure to restore flexor tendon function with a few complications.

我们报告了12例(12根手指)分期屈指肌腱损伤重建的疗效,患者II区屈指肌腱损伤的一期修复被忽略或失败。指深屈肌(FDP) 和指浅屈肌(FDS)均受损伤,预后差(博伊斯等级II-IV)。重建过程包括:第一阶段,放置硅胶棒并在指深屈肌(FDP) 和指浅屈肌(FDS)之间建立循环;第二阶段,通过硅胶棒周围形成的伪鞘反映后者作为椎弓根移植。平均随访18个月(12-30个月不等),根据临床检验和问卷调查评估预后。手指平均总活动范围为188°。健侧平均力性抓握为80%,抓捏为76%。根据Buck-Gramcko评分,预后优良率为75%。结果比患者给出的主观评分更高。并发症表现为:2例术后血肿、1例感染、1例硅胶滑膜炎(I期后)以及3例屈曲痉缩(II期后)。研究表明采用两期屈肌肌腱重建联合技术修复屈肌肌腱功能有用,并发症少。

 

 

由MediCool医库软件 余晓倩 编译

原文来自Indian J Plast Surg