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[Ⅱd区双肌腱修复术后鞘管的处理]

[Management of sheath after repair of double tendons in zone II d].

作者信息

Gu Yu-tong, Tang Jin-bo, Xie Ren-guo, Xu Yan, Yu Xiao-wei, Chen Feng

机构信息

Hand Surgery Center, Department of Orthopedics, Affiliated Hospital, Nantong Medical College, Nantong Jiangsu, P.R. China 226001.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2003 May;17(3):223-6.

Abstract

OBJECTIVE

To evaluate the management of sheath after repair of double tendons in clean-cut injury or severe injury in zone II d.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

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。

结果

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)。

结论

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。

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