Tropet Y, Menez D, Dreyfus-Schmidt G, Vichard P
Service de Traumatologie-Orthopédie, CHU de Besanon, Hôpital Jean Minjoz.
Ann Chir Main. 1988;7(2):109-14. doi: 10.1016/s0753-9053(88)80045-0.
In this study, the authors analyze 197 recent injuries of the flexor tendons of fingers in zones I, II and III of Verdan, without complex cutaneous lesions, associated with an injury of one or both digital nerves, but leaving safe at least one digital artery. Tendon repair is either followed by strict immobilization or by Kleinert's method of immobilization. Results concerning 115 reviewed injuries evaluated according to Kleinert's criteriae, show a net superiority of Kleinert's technique compared to strict immobilization. Global results are analysed according to the age, the finger injured and the presence of a work accident. Lesions treated by Kleinert's technique have been analyzed according to the zone of injury, the tendon injured in zone II and the existence or not of an injured digital nerve. After Kleinert's method, factors affecting the prognosis are lesions in zone II, injury of both tendons, lesions of the fifth finger, the responsibility of a "work accident". The authors conclude as to the correct time for repair, the tendons to be repaired and the type of injuries to be immobilized. They also emphasize the progress brought to the surgery of flexor tendons by Kleinert's method.
在本研究中,作者分析了197例近期发生在韦尔丹I区、II区和III区的手指屈肌腱损伤,这些损伤无复杂皮肤损伤,伴有一条或两条指神经损伤,但至少保留一条指动脉。肌腱修复术后要么采用严格固定,要么采用克莱内特固定法。根据克莱内特标准对115例复查损伤的结果进行评估,结果显示克莱内特技术相对于严格固定具有明显优势。根据年龄、受伤手指和工伤事故情况对总体结果进行分析。对采用克莱内特技术治疗的损伤,根据损伤区域、II区损伤的肌腱以及指神经是否损伤进行分析。采用克莱内特方法后,影响预后的因素包括II区损伤、两条肌腱均损伤、小指损伤以及“工伤事故”责任。作者得出了关于修复的正确时间、待修复的肌腱以及需固定的损伤类型的结论。他们还强调了克莱内特方法给屈肌腱手术带来的进展。