Schöffl Volker, Heid Andreas, Küpper Thomas
Volker Schöffl, Department of Sportorthopedics and Sportsmedicine, Klinikum Bamberg, 96049 Bamberg, Germany.
World J Orthop. 2012 Jun 18;3(6):62-9. doi: 10.5312/wjo.v3.i6.62.
Tendon injuries are the second most common injuries of the hand and therefore an important topic in trauma and orthopedic patients. Most injuries are open injuries to the flexor or extensor tendons, but less frequent injuries, e.g., damage to the functional system tendon sheath and pulley or dull avulsions, also need to be considered. After clinical examination, ultrasound and magnetic resonance imaging have proved to be important diagnostic tools. Tendon injuries mostly require surgical repair, dull avulsions of the distal phalanges extensor tendon can receive conservative therapy. Injuries of the flexor tendon sheath or single pulley injuries are treated conservatively and multiple pulley injuries receive surgical repair. In the postoperative course of flexor tendon injuries, the principle of early passive movement is important to trigger an "intrinsic" tendon healing to guarantee a good outcome. Many substances were evaluated to see if they improved tendon healing; however, little evidence was found. Nevertheless, hyaluronic acid may improve intrinsic tendon healing.
肌腱损伤是手部第二常见的损伤，因此是创伤和骨科患者中的一个重要话题。大多数损伤是屈指肌腱或伸指肌腱的开放性损伤，但也需要考虑一些不太常见的损伤，例如功能系统腱鞘和滑车损伤或钝性撕脱伤。经过临床检查，超声和磁共振成像已被证明是重要的诊断工具。肌腱损伤大多需要手术修复，远节指骨伸肌腱的钝性撕脱伤可接受保守治疗。屈指腱鞘损伤或单个滑车损伤采用保守治疗，多个滑车损伤则接受手术修复。在屈指肌腱损伤的术后过程中，早期被动活动原则对于引发“内在”肌腱愈合以确保良好预后很重要。人们评估了许多物质以确定它们是否能改善肌腱愈合；然而，几乎没有发现相关证据。尽管如此，透明质酸可能会改善内在肌腱愈合。
