Ennaciri Badr, Mahfoud Mustapha, El Bardouni Ahmed, Berrada Mohamed Saleh
Department of Orthopedics, Avicenna University Hospital, Rabat, Morocco.
Pan Afr Med J. 2015 Nov 20;22:266. doi: 10.11604/pamj.2015.22.266.7495. eCollection 2015.
Hand wounds are common, poor functional outcomes are marked because of sequelae inherent to posttraumatic and postoperative complications. Suitable surgery repair in emergency can ensure best results. Classically, tendon's injuries occur near the injured area and their repair depend on traumatized zone, sutures techniques, associated lesions and surgeon's abilities. We report a case of a farmer who has sustained of a severe hand wound due to blades of a combine harvester. Clinical examination showed exceptional laceration of 2(nd) and 3(rd) flexor digitorum tendons from musculo-tendinous junction, without any lesion in their palmar section. We proceeded; after extensive debridement, abundant lavage and removal of foreign body; to modified Kessler sutures using PDS 4.0 followed by dorsal splint for protecting tendons repair, and progressive rehabilitation program. Final result was interesting after 12 weeks. Thinking to tendon laceration is important, when manipulating machines with rotational movements.
手部创伤很常见，由于创伤后和术后并发症所固有的后遗症，功能预后较差。急诊时进行合适的手术修复可确保最佳效果。传统上，肌腱损伤发生在受伤区域附近，其修复取决于创伤区域、缝合技术、相关损伤和外科医生的能力。我们报告一例农民因联合收割机刀片导致严重手部创伤的病例。临床检查显示，第2和第3指屈肌腱在肌肉肌腱交界处出现罕见的撕裂伤，其掌部无任何损伤。我们在进行广泛清创、大量冲洗和清除异物后，使用4.0的聚对二氧环己酮进行改良凯斯勒缝合，随后使用背侧夹板保护肌腱修复，并实施渐进性康复计划。12周后最终结果良好。在操作有旋转运动的机器时，考虑到肌腱撕裂很重要。
