El-Shebly A, El Fahar M, Mohammed H, Bahaa Eldin A
1 Plastic & Reconstructive Surgery Department, Mansoura University, Mansoura, Egypt.
2 General Surgery Department, Mansoura University, Mansoura, Egypt.
J Hand Surg Eur Vol. 2017 Nov;42(9):903-908. doi: 10.1177/1753193417711596. Epub 2017 Jun 11.
We report outcomes of repairing the lacerated A2 pulley with extensor retinaculum graft in ten patients (ten fingers) during primary flexor tendon repair in zone 2. Complete A2 pulley lacerations were found in eight fingers and partial A2 pulley laceration in two. We extended the laceration in the sheath to the middle of the A4 or A1 pulley to allow tendon repair with a four-strand core suture. The A2 pulley was reconstructed with an extensor retinaculum graft. All patients followed the early controlled active mobilization protocol and recovered active range of motion at the interphalangeal joints without major extension deficits. Using the Strickland and Glogovac criteria, there were four excellent, five good and one fair result. One finger was graded excellent, eight good, and one fair according to Tang's criteria. No clinical bowstringing was observed. We conclude that extensive pulley lacerations reconstructed with extensor retinaculum primarily ensure functional recovery after tendon repair.
IV.
我们报告了在2区一期屈肌腱修复术中，用伸肌支持带移植物修复10例患者（10根手指）的A2滑车撕裂伤的结果。8根手指发现A2滑车完全撕裂，2根手指为部分撕裂。我们将腱鞘内的撕裂口延伸至A4或A1滑车中部，以便用四股核心缝线修复肌腱。用伸肌支持带移植物重建A2滑车。所有患者均遵循早期控制下的主动活动方案，指间关节恢复了主动活动范围，无明显伸展受限。根据Strickland和Glogovac标准，结果为优4例、良5例、可1例。根据Tang标准，1根手指为优，8根为良，1根为可。未观察到临床弓弦现象。我们得出结论，用伸肌支持带重建广泛的滑车撕裂伤主要可确保肌腱修复后的功能恢复。
IV级。
