部分指深屈肌腱转位修复软组织型伸肌腱Ⅰ区止点损伤
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摘要
目的探讨应用部分指深屈肌腱转位修复软组织型伸肌腱Ⅰ区止点损伤的方法和疗效。方法本组40例,将2017年1月-6月入院的前20名患者作为对照组,2017年7月-12月入院的前20名患者作为观察组。对照组应用锚钉修复指伸肌腱止点损伤,观察组应用部分指深屈肌腱转位修复软组织型伸肌腱Ⅰ区止点损伤,术后康复训练12周。结果康复结束后应用ELINK测量远指间关节、近指间关节及掌指关节活动角度,采用美国手外科学会(ASSH)TAM分级系统评分:对照组:优5例,良8例,可5例,差2例。观察组:优10例,良9例,可1例,差0例。观察组术后效果优于对照组。结论部分指深屈肌腱转位修复软组织型伸肌腱Ⅰ区止点损伤的手术方法临床效果满意,值得推广。
Objective To evaluate the application and efficacy of Partial flexor digitorum profundus tendon dorsal transposition for reconstruction extensor Ⅰ zone. Mothods This group of 40 cases,selected patients were randomly divided into control group(2017.1.1-2017.6.30, before 20 patients) and experimental group(2017.7.1-2017.12.31, 20 patients before hospital).The control group used the anchor nail repair of finger extensor tendon insertion point, the experimental points are the partial flexor digitorum profundus tendon dorsal transposition for reconstruction extensor Ⅰ zone, postoperative rehabilitation 12 weeks. Results Finsh rehabilitation, ELINK was used to measure the motion angle of the distal interphalangeal joint, proximal interphalangeal joint and metacarpal joints. According to the American society of hand surgery(ASSH) TAM grading system was used for scoring: The control group:excellent in 5 cases, good in 8 cases, fair in 5 cases and poor in 2 cases. The experimental group:excellent in 10 cases, good in 9 cases, fair in 1 case, poor in 0 case. After t test of two samples, P <0.05,it was concluded that the two surgical methods had statistical significance. The experimental group had better postoperative effect than the control group. Conclusion Partial flexor digitorum profundus tendon dorsal transposition for reconstruction extensor Ⅰ zone surgical method provided a satisfactory restoration of extensor tendon insertion point method, is worth promoting.
Objective To evaluate the application and efficacy of Partial flexor digitorum profundus tendon dorsal transposition for reconstruction extensor Ⅰ zone. Mothods This group of 40 cases,selected patients were randomly divided into control group(2017.1.1-2017.6.30, before 20 patients) and experimental group(2017.7.1-2017.12.31, 20 patients before hospital).The control group used the anchor nail repair of finger extensor tendon insertion point, the experimental points are the partial flexor digitorum profundus tendon dorsal transposition for reconstruction extensor Ⅰ zone, postoperative rehabilitation 12 weeks. Results Finsh rehabilitation, ELINK was used to measure the motion angle of the distal interphalangeal joint, proximal interphalangeal joint and metacarpal joints. According to the American society of hand surgery(ASSH) TAM grading system was used for scoring: The control group:excellent in 5 cases, good in 8 cases, fair in 5 cases and poor in 2 cases. The experimental group:excellent in 10 cases, good in 9 cases, fair in 1 case, poor in 0 case. After t test of two samples, P <0.05,it was concluded that the two surgical methods had statistical significance. The experimental group had better postoperative effect than the control group. Conclusion Partial flexor digitorum profundus tendon dorsal transposition for reconstruction extensor Ⅰ zone surgical method provided a satisfactory restoration of extensor tendon insertion point method, is worth promoting.
引文
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[10]胡洪涌,赵小伟,窦庆寅,等.指伸肌腱止点形态特点与损伤分型及治疗方法[J].中国临床解剖学杂志,2011,29(4):458-460.
[11]王凯,金光哲,郭礼平,等.微型锚钉在开放性伸肌腱止点损伤中的应用[J].实用手外科杂志,2017,31(1):27-29.
[12]何家强,陈伟,沈焕武,等.带线骨锚钉联合克氏针急诊修复指伸肌腱止点断裂20例[J].实用手外科杂志,2017,31(3):310-311.
[2]Ahmad F,Pickford M.Reconstruction of the extensor central slip using a distally based flexor digitorum superficialis slip[J].Hand Surg,2009,34(5):930-932.
[3]吴兴,阚世廉,陈广先,等.指浅屈肌腱部分腱束转位重建伸肌腱中央束[J].中华手外科杂志,2016,10(3):361-362.
[4]谢浩,顾永平,杨业林,等.掌长肌腱移植修复Ⅰ区指伸肌腱断裂[J].中华手外科杂志,2013,10(3):311-312.
[5]俞俊兴,李向荣,秦军,等.上肢主要血管闭合性损伤的诊治[J].中华手外科杂志,2013,5(3):312-314.
[6]蔡锦芳,丁自海,陈中伟.显微足外科学[M].济南:山东科学技术出版社,2002.755-757.
[7]刘璠,侍德.从力学角度探讨Ⅰ区伸肌腱断裂疗效不佳原因[J].中华手外科杂志,1994,10(1):31-33.
[8]赵占稳.陈旧性腱性锤状指的显微外科手术治疗[J].中国矫形外科杂志,2008,16(18):1898-1899.
[9]曹曼林,周俊,马峥.综合康复疗法治疗指伸肌腱粘连的临床观察[J].中华手外科杂志,2013,29(1):55-56.
[10]胡洪涌,赵小伟,窦庆寅,等.指伸肌腱止点形态特点与损伤分型及治疗方法[J].中国临床解剖学杂志,2011,29(4):458-460.
[11]王凯,金光哲,郭礼平,等.微型锚钉在开放性伸肌腱止点损伤中的应用[J].实用手外科杂志,2017,31(1):27-29.
[12]何家强,陈伟,沈焕武,等.带线骨锚钉联合克氏针急诊修复指伸肌腱止点断裂20例[J].实用手外科杂志,2017,31(3):310-311.