Zhu Wei, Li Yucheng, Shen Cheng, Hu Qi, Zhu Jin, Yang Chen
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2015 Jul;29(7):818-21.
To discuss the effectiveness of operative treatments for different kinds of old injury of extensor tendon in zone II so as to choose the best surgical approach based on the classification of injury.
Between May 2006 and May 2014, 68 cases of old injury of extensor tendon in zone II were treated. Among them, there were 50 males and 18 females with an average age of 36 years (range, 18-52 years). The causes included contusion injury in 50 cases, avulsion injury in 11 cases, and burn injury in 7 cases. The left side was involved in 21 cases and the right side in 47 cases. The injured finger involved the index finger in 18 cases, the middle finger in 21 cases, the ring finger in 24 cases, and the little finger in 5 cases. The disease duration was 1.5 months to 1 year (mean, 6.75 months). The central slip of extensor was repaired directly in 32 patients who had normal passive motion. Side cross stitch (8 cases) or Littler-Eaton (10 cases) method was used in 18 patients who can not extend actively and passively. Tendon graft was performed in 11 patients with tendon defect. Joint release was given in 7 patients with contracture after burn injury.
Primary healing of incision was obtained in all cases. Sixty-eight cases were followed up 3-12 months (mean, 6.9 months). Three cases had tendon adhesion in varying degrees and suffered from pain, which was treated conservatively by functional exercise. Recurrence was observed in 2 cases, and extensor tendon was repaired again. According to total active motion (TAM) function assessment, the results were excellent in 52 cases, good in 11 cases, fair in 3 cases, and poor in 2 cases with an excellent and good rate of 92.6%.
Adaptive operation method for old injury of extensor tendon in zone II should be selected based on the type of injury. The results will be satisfactory if correct method is chosen.
探讨Ⅱ区不同类型伸指肌腱陈旧性损伤的手术治疗效果，以便根据损伤分类选择最佳手术方法。
2006年5月至2014年5月，治疗68例Ⅱ区伸指肌腱陈旧性损伤患者。其中男性50例，女性18例，平均年龄36岁（18 - 52岁）。致伤原因包括挫伤50例，撕脱伤11例，烧伤7例。左侧损伤21例，右侧损伤47例。受伤手指中，示指18例，中指21例，环指24例，小指5例。病程为1.5个月至1年（平均6.75个月）。32例被动活动正常的患者直接修复伸指中央束。18例主动和被动均不能伸直的患者采用侧方十字缝合法（8例）或Littler - Eaton法（10例）。11例肌腱缺损患者行肌腱移植。7例烧伤后挛缩患者行关节松解术。
所有病例切口均一期愈合。68例患者随访3 - 12个月（平均6.9个月）。3例出现不同程度的肌腱粘连并伴有疼痛，经功能锻炼保守治疗。2例复发，再次行伸指肌腱修复术。根据总主动活动度（TAM）功能评估，结果为优52例，良11例，可3例，差2例，优良率为92.6%。
Ⅱ区伸指肌腱陈旧性损伤应根据损伤类型选择合适的手术方法。选择正确的方法可获得满意疗效。
