al-Qattan M M
Division of Plastic Surgery, King Saudi University, Riyadh, Saudi Arabia.
J Hand Surg Am. 2000 Nov;25(6):1118-21. doi: 10.1053/jhsu.2000.18486.
Over a 5-year-period 15 patients with zone II partial flexor tendon lacerations that were larger than half the width of the tendon were treated conservatively without tendon suturing. Surgical exploration was done with a digital block and the flexor tendons were observed as the patient fully extended and flexed the finger. If present, the cause of triggering was determined and eliminated by trimming any beveled tendon edge, resection of the involved pulleys, and repair of the flexor sheath. Early protected mobilization was started the first day after injury using a dorsal splint. At 4 weeks after injury the splint was removed and exercises against resistance were started. None of the patients had triggering or rupture of the flexor tendons. Using the Strickland-Glogovac evaluation method, results were excellent in 93% of cases and good in the remaining 7%. It was concluded that conservative management of zone II partial flexor tendon lacerations larger than half the width of the tendon is safe as long as certain guidelines regarding the prevention of triggering and protected mobilization are applied.
在5年期间，对15例Ⅱ区部分屈肌腱裂伤且裂伤大于肌腱宽度一半的患者进行了保守治疗，未进行肌腱缝合。在指神经阻滞下进行手术探查，当患者完全伸展和屈曲手指时观察屈肌腱。如果存在弹响，通过修整任何成斜面的肌腱边缘、切除受累滑车和修复屈肌腱鞘来确定并消除弹响原因。受伤后第一天使用背侧夹板开始早期保护性活动。受伤4周后去除夹板并开始抗阻练习。所有患者均未出现屈肌腱弹响或断裂。采用Strickland-Glogovac评估方法，93%的病例结果为优，其余7%为良。得出的结论是，只要应用关于预防弹响和保护性活动的某些指导原则，对Ⅱ区大于肌腱宽度一半的部分屈肌腱裂伤进行保守治疗是安全的。
