Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.
J Am Acad Orthop Surg. 2011 Mar;19(3):152-62. doi: 10.5435/00124635-201103000-00004.
Avulsions of the flexor digitorum profundus tendon may involve tendon retraction into the palm and fractures of the distal phalanx. Although various repair techniques have been described, none has emerged as superior to others. Review of the literature does provide evidence-based premises for treatment: multi-strand repairs perform better, gapping may be seen with pullout suture-dorsal button repairs, and failure because of bone pullout remains a concern with suture anchor methods. Clinical prognostic factors include the extent of proximal tendon retraction, chronicity of the avulsion, and the presence and size of associated osseous fragments. Patients must be counseled appropriately regarding anticipated outcomes, the importance of postoperative rehabilitation, and potential complications. Treatment alternatives for the chronic avulsion injury remain patient-specific and include nonsurgical management, distal interphalangeal joint arthrodesis, and staged reconstruction.
屈指深肌腱撕脱伤可导致肌腱回缩至手掌，并伴有远节指骨骨折。尽管已经描述了各种修复技术，但尚无一种技术优于其他技术。文献复习确实为治疗提供了循证依据：多股修复效果更好，抽芯缝线-背侧纽扣修复可能出现间隙，缝线锚钉方法因骨拔出而失败仍然是一个关注点。临床预后因素包括近端肌腱回缩的程度、撕脱的慢性程度以及伴随的骨碎片的存在和大小。必须向患者适当告知预期结果、术后康复的重要性以及潜在并发症。慢性撕脱伤的治疗选择仍然是个体化的，包括非手术治疗、远侧指间关节融合术和分期重建。
