Nunley J A, Levin L S, Devito D, Goldner R D, Urbaniak J R
Duke University Medical Center, Durham, NC 27710.
J Hand Surg Am. 1992 Jan;17(1):118-21. doi: 10.1016/0363-5023(92)90126-a.
Between 1976 and 1986, 38 consecutive acute isolated flexor pollicis longus lacerations were repaired. This study excluded all replanted or mutilated digits and all lacerations with associated fracture. Average follow-up was 26 months. Tendon rehabilitation was standardized. Range of motion and pinch strength were measured postoperatively. Seventy-four percent (28/38) of the flexor pollicis longus injuries occurred in zone II. Neurovascular injury occurred in 82% of the lacerations, and this correlated with the zone of tendon injury. In 21% of the patients (8/38) both digital nerves and arteries were transected. Postoperative thumb interphalangeal motion averaged 35 degrees and key pinch strength was 81% that of the uninjured thumb. One rupture occurred in a child. Laceration of the flexor pollicis longus is likely to involve damage to neurovascular structures, and repair may be necessary. Direct end-to-end repairs within the pulley system do at least as well as delayed tendon reconstruction and do not require additional procedures.
1976年至1986年间，连续修复了38例急性孤立性拇长屈肌腱撕裂伤。本研究排除了所有再植或毁损的手指以及所有合并骨折的撕裂伤。平均随访时间为26个月。肌腱康复治疗标准化。术后测量活动范围和捏力。74%（28/38）的拇长屈肌损伤发生在Ⅱ区。82%的撕裂伤伴有神经血管损伤，且这与肌腱损伤区域相关。21%的患者（8/38）指神经和动脉均被横断。术后拇指指间关节活动平均为35度，关键捏力为健侧拇指的81%。1例儿童发生了1次肌腱断裂。拇长屈肌腱撕裂伤可能累及神经血管结构，可能需要进行修复。在滑车系统内行直接端端修复至少与延迟肌腱重建效果相同，且无需额外手术。
