Moriya K, Yoshizu T, Tsubokawa N, Narisawa H, Hara K, Maki Y
Niigata Hand Surgery Foundation, Niigata, Japan
Niigata Hand Surgery Foundation, Niigata, Japan.
J Hand Surg Eur Vol. 2016 Oct;41(8):822-8. doi: 10.1177/1753193416646521. Epub 2016 May 12.
We report the results of complete release of the entire A2 pulley after zone 2C flexor tendon repair followed by early postoperative active mobilization in seven fingers and their comparisons with 33 fingers with partial A2 pulley release. In seven fingers, release of the entire A2 pulley was necessary to allow free gliding of the repairs in five fingers and complete release of both the A2 and C1 pulleys was necessary in two. No bowstringing was clinically evident in any finger. Two fingers required tenolysis. Using Tang's criteria, the function of two digits was ranked as excellent, four good and one fair; there was no failure. The functional return in these seven fingers was similar with that in 33 fingers with partial A2 pulley release; in these patients only one finger required tenolysis. Our results support the suggestion that release of the entire A2 pulley together with the adjacent C1 pulley does not clinically affect finger motion or cause tendon bowstringing, provided that the other pulleys are left intact.
IV.
我们报告了在2C区屈指肌腱修复后完全松解整个A2滑车并在术后早期进行主动活动的7根手指的结果，并将其与33根进行部分A2滑车松解的手指进行比较。在7根手指中，5根手指需要完全松解整个A2滑车以允许修复处自由滑动，2根手指需要同时完全松解A2和C1滑车。临床上未发现任何手指有弓弦状畸形。2根手指需要进行肌腱松解术。根据唐的标准，2根手指功能评为优，4根为良，1根为可；无失败病例。这7根手指的功能恢复与33根进行部分A2滑车松解的手指相似；在这些患者中只有1根手指需要进行肌腱松解术。我们的结果支持这样的观点，即只要其他滑车保持完整，完全松解整个A2滑车及相邻的C1滑车在临床上不会影响手指活动或导致肌腱弓弦状畸形。
IV级。
