Ross Douglas C, Manktelow Ralph T, Wells Mark T, Boyd J Brian
Hand & Upper Limb Centre, St. Joseph's Health Centre, University of Western Ontario, London, Ontario, Canada.
Ann Plast Surg. 2003 Aug;51(2):141-6. doi: 10.1097/01.SAP.0000058499.74279.D8.
The purpose of this study was to determine the important prognostic factors for recovery of tendon function as measured by total active movement (TAM) in patients undergoing digital replantation. More important, the authors wanted to establish which factors may be manipulated to maximize motion. A retrospective review of 48 patients (103 digital rays) who underwent replantation was performed. Average TAM for all digits was 129 deg. Zone 1 and zone 5 injuries had better TAM than injuries in zones 2, 3, and 4, which had TAM values not significantly different from one another. Avulsion injuries fared significantly worse than other mechanisms of injury. TAM values were not affected by age, type of bone fixation, number of arteries repaired, or number of digits injured. Digits with both the profundus and the superficialis tendons repaired had significantly better TAM values relative to one-tendon fingers. Similarly, fingers treated with an "early" mobilization regime also exhibited better movement. Small numbers of injured digits in some groups may have limited our ability to detect significant differences.
本研究的目的是确定在接受断指再植的患者中，以总主动活动度（TAM）衡量的肌腱功能恢复的重要预后因素。更重要的是，作者希望确定哪些因素可以进行调控以最大限度地恢复活动度。对48例（103条手指）接受再植手术的患者进行了回顾性研究。所有手指的平均TAM为129度。1区和5区损伤的TAM优于2区、3区和4区损伤，2区、3区和4区损伤的TAM值彼此之间无显著差异。撕脱伤的情况明显比其他损伤机制更糟。TAM值不受年龄、骨固定类型、修复动脉数量或受伤手指数量的影响。同时修复了指深屈肌腱和指浅屈肌腱的手指相对于仅修复一条肌腱的手指，其TAM值明显更好。同样，采用“早期”活动方案治疗的手指也表现出更好的活动度。某些组中受伤手指数量较少可能限制了我们检测显著差异的能力。
