Winkel R, Kalbhenn O, Hoffmann R
BG-Unfallklinik, Handchirurgie, Plastische Chirurgie, Frankfurt am Main.
Handchir Mikrochir Plast Chir. 2012 Jun;44(3):129-34. doi: 10.1055/s-0032-1304306. Epub 2012 May 14.
This retrospective examination compares the results of finger flexor tendon sutures with 2 strands and 4 strands. It was checked, whether and how 2 more strands influenced the rupture rate, the movement of the finger and the contentment of the patients.
From 1996 to 2000 for the core suture of the flexor tendon of fingers we used 2 strands. 35 patients with 40 tendon sutures of 73 patients were examined. From 2001 to 2005 we used for the core suture 2 loop threads. 53 patients with 64 tendon sutures from a total of 111 patients were examined. At least 12 months had passed between operation and the examination. The rupture rate and the range of movement of each finger joint and the total mobility of the affected fingers were evaluated. Each case was compared to the uninjured opposite hand. The functional result was judged according to the score of Buck-Gramcko. The patient's contentment was recorded by the DASH (disability of arm, shoulder and hand) score. Effects of gender, age, accompanying injuries, zone of the injury and their influence on the results were analysed.
The Buck-Gramcko score showed in the 2-strand group a distribution from summarised 70% "excellent" and "good" and 30% "fair" and "poor". In the 4-strand-group the relation was 93.7% "excellent" and "good", 6.3% "fair", one "poor". In the 2-strand group 2/40 (5%) of the tendon sutures ruptured, in the 4-strand group 1/64 (1.6%) ruptured. The average DASH value in the 2-strands-group was 16.6/100, in the 4-strands-group 18.1/100 when 0 is the best possible result and 100 the worst. The patient judgement in the 2-strand group was summarised to 70% for "excellent" and "good" and 30% "fair" and "poor". In the 4-strand group the patient's judgment was summarised in 75% "excellent" and "good" and in 25% "fair".
The results of flexor tendon sutures with 4-strand core sutures have been superior to the results with 2-strand core suture according to range of motion of the fingers (P <0.005).
本回顾性研究比较了双股和四股手指屈肌腱缝合的结果。研究检查了额外的两股是否以及如何影响断裂率、手指活动度和患者满意度。
1996年至2000年，我们对手指屈肌腱的核心缝合采用双股线。对73例患者中的40例肌腱缝合的35例患者进行了检查。2001年至2005年，我们对手指屈肌腱的核心缝合采用双环缝线。对111例患者中的64例肌腱缝合的53例患者进行了检查。手术与检查之间至少间隔12个月。评估了每个手指关节的断裂率和活动范围以及患指的总活动度。将每个病例与未受伤的对侧手进行比较。根据Buck-Gramcko评分判断功能结果。通过DASH（上肢、肩部和手部功能障碍）评分记录患者的满意度。分析了性别、年龄、合并伤、损伤部位及其对结果的影响。
Buck-Gramcko评分显示，双股线组中总结为70%为“优”和“良”，30%为“中”和“差”。在四股线组中，这一比例为93.7%为“优”和“良”，6.3%为“中”，1例为“差”。双股线组中2/40（�%）的肌腱缝合发生断裂，四股线组中1/64（1.6%）发生断裂。双股线组的平均DASH值为16.6/100，四股线组为18.1/100，0为最佳结果，100为最差结果。双股线组患者的评价总结为70%为“优”和“良”，30%为“中”和“差”。在四股线组中，患者的评价总结为75%为“优”和“良”，25%为“中”。
根据手指活动范围，四股核心缝合的屈肌腱缝合结果优于双股核心缝合（P<0.005）。
