Tang Jin Bo, Xie Ren Guo, Cao Yi, Ke Zun San, Xu Yan
Department of Hand Surgery, Hand Surgery Research Center, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
Clin Orthop Relat Res. 2007 Mar;456:121-7. doi: 10.1097/01.blo.0000246564.96208.b0.
Outcomes of flexor tendon repairs in the area covered by major pulleys are often unpredictable. We performed an in vivo study to investigate biomechanical effects of pulley incision, Kapandji pulley plasty, excision of one slip of the flexor digitorum superficialis, or closure of the incised pulley on function of the profundus tendons. Both long toes (104 total) of 52 leghorn chickens were divided into four experimental groups and one control group. The pulley and flexor digitorum superficialis tendon were subjected to the above-mentioned treatments in four groups, with 22 toes per group, after tendon transection in the A2 pulley area. Eight weeks after surgery, incision of the pulley improved excursion of the flexor digitorum profundus tendon and decreased the work of digital flexion over pulley closure. Resection of the one slip of the flexor digitorum superficialis tendon had results similar to pulley incision. Kapandji pulley plasty did not increase tendon excursion and decrease the work compared with a simpler pulley incision. Adhesions were more severe with pulley plasty or closure than with pulley incision. In this avian model, incision of the pulley or partial flexor digitorum superficialis resection improved outcomes of tendon repairs compared with pulley closure. Kapandji pulley plasty did not improve the outcomes over a simple pulley incision.
在主要滑车覆盖区域进行屈指肌腱修复的结果往往不可预测。我们进行了一项体内研究，以调查滑车切开、卡潘迪滑车成形术、切除指浅屈肌一条肌腱束或缝合切开的滑车对指深屈肌腱功能的生物力学影响。将52只来亨鸡的双侧长趾（共104个）分为四个实验组和一个对照组。在A2滑车区域切断肌腱后，对四个实验组的滑车和指浅屈肌腱进行上述处理，每组22个趾。术后8周，滑车切开术改善了指深屈肌腱的滑动，并减少了滑车缝合后手指屈曲的做功。切除指浅屈肌一条肌腱束的结果与滑车切开术相似。与简单的滑车切开术相比，卡潘迪滑车成形术并未增加肌腱滑动且未减少做功。滑车成形术或缝合后的粘连比滑车切开术更严重。在这个禽类模型中，与滑车缝合相比，滑车切开术或部分切除指浅屈肌可改善肌腱修复的结果。卡潘迪滑车成形术与简单的滑车切开术相比并未改善结果。
