Feldscher Sheri B, Schneider Lawrence H
The Philadelphia Hand Center, P. C. Philadelphia, PA 19107, USA.
Hand Surg. 2002 Jul;7(1):61-74. doi: 10.1142/s0218810402000819.
Tenolysis is a well-established salvage procedure, which can be applied when non-gliding adhesions form along the surface of a tendon after injury or repair and prevent gliding of the tendon in the performance of its intended function.(8,15,17,29,30,39,40,44,49) Tendon adhesions will occur whenever the surface of a tendon is damaged either through the injury itself, be it laceration or crush, or by surgical manipulation.(18) At any point on the surface of a tendon where violation occurs, an adhesion will form in the healing period.(20,26) When these adhesions cannot be mobilised by an adequate course of hand therapy, tenolysis should be considered. This procedure is as difficult or more so than tendon repair itself and should not be undertaken lightly. It represents another surgical incursion into an area of previous trauma and surgery. If the procedure is not successful, the patient's hand may show no improvement or even be worse. The risk of further decreasing the circulatory supply and innervation to an already deprived finger is a real one. Rupture of the lysed tendon, a disastrous complication, is the major hazard of tenolysis.
肌腱松解术是一种成熟的挽救手术,当损伤或修复后肌腱表面形成非滑动性粘连并在肌腱执行其预期功能时阻止其滑动时,可应用该手术。(8,15,17,29,30,39,40,44,49)无论肌腱表面是因损伤本身(无论是撕裂还是挤压)还是手术操作而受损,都会发生肌腱粘连。(18)在肌腱表面任何发生损伤的部位,愈合期都会形成粘连。(20,26)当这些粘连无法通过适当疗程的手部治疗松解时,应考虑进行肌腱松解术。该手术与肌腱修复本身一样困难甚至更难,不应轻易进行。它代表着对先前创伤和手术区域的又一次手术侵入。如果手术不成功,患者的手部可能没有改善甚至更糟。进一步减少已缺血手指的血液循环供应和神经支配的风险是切实存在的。松解后的肌腱断裂是一种灾难性并发症,是肌腱松解术的主要风险。