Gu Yu-tong, Tang Jin-bo, Xie Ren-guo, Xu Yan, Yu Xiao-wei, Chen Feng
Hand Surgery Center, Department of Orthopedics, Affiliated Hospital, Nantong Medical College, Nantong Jiangsu, P.R. China 226001.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2003 May;17(3):223-6.
To evaluate the management of sheath after repair of double tendons in clean-cut injury or severe injury in zone II d.
Forty-eight white leghorn chickens were divided into 4 groups. Both FDS and FDP tendons in zone II d of long toes were repaired with modified Kessler suture after tendon transection in group A (clean-cut tendon injury, sheath closure), group B (clean-cut tendon injury, sheath excision), group C (severe tendon injury, sheath closure) and group D (severe tendon injury, sheath excision), respectively. Biomechanical studies of gliding excursion and work of flexion were carried out 6 weeks and 12 weeks after tendon repair. The extent of adhesion was examined.
After 6 and 12 weeks of repair, there were no significant differences in tendon excursion and work of flexion of the toes between groups A and B. Excursions of FDP tendons in group D was significantly larger than that in group C (P < 0.05). Work of flexion and extent of adhesion in group D was significantly less than that in group C (P < 0.05).
The above results indicate that sheath can be closed after repair of both FDS and FDP tendons in clean-cut injury and that sheath should be excised in severe injury in zone II d.
评估Ⅱ区d型锐器伤或严重损伤中双肌腱修复术后鞘管的处理方法。
48只白色来亨鸡分为4组。A组（锐器切割肌腱损伤，鞘管闭合）、B组（锐器切割肌腱损伤，鞘管切除）、C组（严重肌腱损伤，鞘管闭合）和D组（严重肌腱损伤，鞘管切除）分别对长趾Ⅱ区d型的指浅屈肌腱（FDS）和指深屈肌腱（FDP）进行肌腱横断后用改良Kessler缝合法修复。肌腱修复后6周和12周进行滑动距离和屈曲功的生物力学研究，并检查粘连程度。
修复6周和12周后，A组和B组之间的肌腱滑动距离和足趾屈曲功无显著差异。D组FDP肌腱的滑动距离显著大于C组（P<0.05）。D组的屈曲功和粘连程度显著小于C组（P<0.05）。
上述结果表明，Ⅱ区d型锐器伤中FDS和FDP肌腱修复后鞘管可以闭合，而严重损伤时鞘管应切除。
