Dy Christopher J, Daluiski Aaron
J Am Acad Orthop Surg. 2014 Dec;22(12):791-9. doi: 10.5435/JAAOS-22-12-791.
Flexor tendon repair in zone II is particularly challenging because tendon gliding must be restored within a tight fibro-osseous sheath while minimizing the formation of adhesions in surrounding tissues. Meticulous surgical technique using a multistrand core suture and a peripheral suture is needed to produce a tendon that is strong enough to withstand early mobilization. Mechanical strength increases with the number of strands crossing the repair, regardless of the core suture configuration. Early mobilization after flexor tendon repair enhances the strength of the repair and decreases the risk of adhesions and joint stiffness. Satisfactory results have been achieved with either early passive or early active motion rehabilitation protocols; therefore, the choice of postoperative rehabilitation program is at the discretion of the surgeon. Factors such as repair integrity, concurrent injuries, and anticipated patient compliance should be considered in the decision-making process.
在II区进行屈肌腱修复极具挑战性，因为必须在紧密的纤维骨鞘内恢复肌腱滑动，同时尽量减少周围组织粘连的形成。需要采用多股核心缝线和周边缝线的精细手术技术，以制作出足够强壮以承受早期活动的肌腱。无论核心缝线的构型如何，机械强度都会随着穿过修复处的股数增加而增强。屈肌腱修复后早期活动可增强修复强度，降低粘连和关节僵硬的风险。早期被动或早期主动运动康复方案均取得了满意的效果；因此，术后康复方案的选择由外科医生自行决定。在决策过程中应考虑修复完整性、并发损伤和预期患者依从性等因素。
