Ozbaydar M, Orman O, Ozel O, Altan E
Orthopedics and Traumatology Department, Acibadem University, İçerenköy Mh. No:32 Kerem Aydınlar Kampüsü, Kayışdağı Cd., 34752 Ataşehir/Istanbul, Turkey.
Orthopedics/Hand Surgery Department, Baltalimani Training and Research Hospital, Baltalimanı Mahallesi, Baltalimanı Hisarüstü Yolu No:5, 34470 Sarıyer/Istanbul, Turkey.
Hand Surg Rehabil. 2017 Dec;36(6):410-415. doi: 10.1016/j.hansur.2017.07.004. Epub 2017 Oct 10.
Treatment of patients with traumatic loss of skin and multiple extensor tendons on the dorsum of the hand is a challenge. The aim of this study was to assess the outcome after reconstruction of soft tissues and multiple extensor tendons in patients who suffered traumatic loss of skin and multiple extensor tendons. Ten patients were enrolled in the study. These patients underwent single-stage reconstruction with autogenous hamstring tendon grafts for multiple extensor tendon defects and fasciocutaneous flaps for coverage of dorsal hand defects. In total, 25 tendons (2 tendons in 5 patients and 3 tendons in 5 patients) were reconstructed. The semitendinosus tendon was used in all patients and the gracilis tendon was added in five patients for tendon reconstruction. Total tendon length requiring reconstruction was between 9cm and 31cm. Free anterolateral thigh flaps were used in six patients and reverse pedicled forearm flaps were used in four patients. According to Miller's scoring system, 8 fingers had excellent results, 12 fingers had good results and 5 fingers had fair results at the final follow-up. Hamstring tendons can be used satisfactorily for primary reconstruction of multiple digital extensor tendons due to their availability and compatibility, with a fasciocutaneous flap.
IV.
手部背侧皮肤及多条伸肌腱外伤性缺失患者的治疗是一项挑战。本研究的目的是评估皮肤及多条伸肌腱外伤性缺失患者软组织和多条伸肌腱重建后的效果。10例患者纳入本研究。这些患者接受了自体腘绳肌腱移植修复多条伸肌腱缺损及筋膜皮瓣覆盖手背缺损的一期重建。共重建25条肌腱（5例患者为2条肌腱，5例患者为3条肌腱）。所有患者均使用半腱肌肌腱，5例患者加用股薄肌肌腱进行肌腱重建。需要重建的肌腱总长度在9cm至31cm之间。6例患者使用游离股前外侧皮瓣，4例患者使用逆行带蒂前臂皮瓣。根据米勒评分系统，末次随访时8指效果优，12指效果良，5指效果可。由于腘绳肌腱易于获取且兼容性良好，可与筋膜皮瓣一起令人满意地用于多条指伸肌腱的一期重建。
IV级。
