Chang Min Kai, Acharyya Sanchalika, Lim Zeus Yiwei, Tay Shian Chao
* Duke-NUS Medical School, Singapore General Hospital, Singapore.
† Biomechanics Laboratory, Singapore General Hospital, Singapore.
J Hand Surg Asian Pac Vol. 2019 Mar;24(1):83-88. doi: 10.1142/S2424835519500152.
The single looped suture modified Lim/Tsai technique is widely used for flexor tendon repairs. It has been shown to possess better biomechanical properties and require less repair time per tendon as compared to the double looped suture original Lim/Tsai technique. However, there is no clinical data on the modified technique.
The retrospective study included zone 2 flexor tendon repairs made using the modified Lim/Tsai technique from January 2008 to December 2014. Clinical outcome was assessed using the revised Strickland and Glogovac criteria, which categorises repairs based on the total active motion of the repaired digit.
Sixty-two patients with 74 digits were included. The overall mean total active motion was 122°. The overall satisfactory outcome of the modified Lim/Tsai technique was 81.1%. The rupture rate of the modified Lim/Tsai technique was 2.7%. Using multivariate linear regression model, we found that outcomes were negatively influenced by subzone 2C and crush/saw injuries, but not by concomitant neurovascular injuries or post-operative follow-up duration.
Based on this retrospective study of patients with zone 2 flexor tendon injuries, the clinical outcomes of modified and original Lim/Tsai techniques are comparable. As such, there is no clinical evidence favouring one over the other.
单环缝合法改良的林/蔡氏技术广泛应用于屈指肌腱修复。与双环缝合法原始林/蔡氏技术相比,已证明其具有更好的生物力学性能,且每条肌腱的修复时间更短。然而,关于改良技术尚无临床数据。
这项回顾性研究纳入了2008年1月至2014年12月期间采用改良林/蔡氏技术进行的Ⅱ区屈指肌腱修复病例。使用修订后的斯特里克兰德和格洛戈瓦茨标准评估临床结果,该标准根据修复手指的总主动活动度对修复情况进行分类。
纳入62例患者共74根手指。总的平均总主动活动度为122°。改良林/蔡氏技术的总体满意结果为81.1%。改良林/蔡氏技术的断裂率为2.7%。使用多元线性回归模型,我们发现结果受到2C亚区以及挤压/锯伤的负面影响,但不受合并神经血管损伤或术后随访时间的影响。
基于对Ⅱ区屈指肌腱损伤患者的这项回顾性研究,改良和原始林/蔡氏技术的临床结果相当。因此,没有临床证据表明一种技术优于另一种。