Harris S B, Harris D, Foster A J, Elliot D
Hand Surgery Department, St Andrew's Centre for Plastic Surgery, Broomfield Hospital, Chelmsford, UK.
J Hand Surg Br. 1999 Jun;24(3):275-80. doi: 10.1054/jhsb.1998.0212.
Five hundred and eight patients with 840 acute complete flexor tendon injuries in 605 fingers in zones 1 and 2 underwent surgery and postoperative mobilization in a controlled or early active motion (active flexion-active extension) regimen over a period of 7.5 years. Sixty-eight patients with 79 finger flexor divisions who did not complete the rehabilitation programme were excluded. Of the 440 patients with 728 complete tendon divisions in 526 fingers included in the study, 23 patients ruptured 28 tendon repair(s) in 23 fingers, an overall rupture rate of 4%. One hundred and twenty-nine fingers with zone 1 injuries had a rupture rate of 5%. Three hundred and ninety-seven fingers with zone 2 injuries had a rupture rate of 4%. This study analyses the 23 patients with flexor tendon rupture(s) to identify causative factors. In approximately half of these patients, tendon rupture followed acts of stupidity. The implications of this are discussed. There was no significant relationship between tendon rupture and the age or sex of the patients, smoking or delay between injury and tendon repair and there was no particular prevalence of zone 2C level injuries among the fingers in which tendon rupture occurred.
508例患者的605根手指在1区和2区发生了840处急性完全屈指肌腱损伤，在7.5年的时间里接受了手术治疗以及术后采用控制活动或早期主动活动（主动屈曲-主动伸展）方案进行的活动。68例患者的79根手指屈肌腱断裂，未完成康复计划，被排除在外。纳入研究的440例患者的526根手指中有728处完全肌腱断裂，其中23例患者的23根手指发生了28处肌腱修复断裂，总体断裂率为4%。129根1区损伤的手指断裂率为5%。397根2区损伤的手指断裂率为4%。本研究分析了23例屈肌腱断裂患者，以确定致病因素。在大约一半的这些患者中，肌腱断裂是由愚蠢行为导致的。对此的影响进行了讨论。肌腱断裂与患者的年龄、性别、吸烟或受伤与肌腱修复之间的延迟没有显著关系，并且在发生肌腱断裂的手指中，2C区水平损伤没有特别的普遍性。
