Al-Qattan Mohammad M
Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia.
Ann Plast Surg. 2012 Jan;68(1):29-32. doi: 10.1097/SAP.0b013e31820e0e19.
A review of the English medical literature over the last 20 years reporting on flexor profundus lacerations revealed only 55 reported cases of zone I flexor profundus lacerations in children. The standard repair technique in young children (5-10 years of age) has been either tendon reinsertion into bone (usually Bunnell technique) for distal zone I injuries or a 2-strand repair (usually modified Kessler technique) for proximal zone I injuries. We report on 22 children (5-10 years of age) with zone I flexor profundus tendon lacerations (10 children had distal zone I injury and 12 had proximal zone I injury) repaired with a 6-strand technique (3 separate "figure of 8" sutures) followed by early postoperative active mobilization. There were no ruptures. Using the Strickland and Glogovac criteria (on the basis of the net active motion of both the interphalangeal joints), all children qualified for an excellent outcome. However, using Moremen and Elliot criteria (on the basis of the net active motion of the distal interphalangeal joint only), 11 children had an excellent outcome, 3 had a good outcome, and 8 had a fair outcome. Our results were compared with previously reported series. It was concluded that the 6-strand figure of 8 suture technique may be used in pediatric zone I injuries and it is strong enough to allow safe early postoperative active mobilization in the 5- to 10-year age group children.
回顾过去20年报道屈指深肌腱裂伤的英文医学文献，仅发现55例儿童I区屈指深肌腱裂伤的报道病例。对于幼儿（5 - 10岁），标准的修复技术是，对于I区远端损伤采用肌腱重新植入骨内（通常采用Bunnell技术），对于I区近端损伤采用双股修复（通常采用改良Kessler技术）。我们报告了22例（5 - 10岁）I区屈指深肌腱裂伤的儿童（10例为I区远端损伤，12例为I区近端损伤），采用6股技术（3根独立的“8”字缝合）修复，术后早期进行主动活动。没有出现断裂情况。根据Strickland和Glogovac标准（基于指间关节的净主动活动度），所有儿童的预后均为优秀。然而，根据Moremen和Elliot标准（仅基于远侧指间关节的净主动活动度），11例儿童预后优秀，3例良好，8例一般。我们将结果与先前报道的系列进行了比较。得出的结论是，6股“8”字缝合技术可用于儿童I区损伤，并且足够牢固，能够让5至10岁儿童在术后早期安全地进行主动活动。
