Venkatramani Hari, Varadharajan Vigneswaran, Bhardwaj Praveen, Vallurupalli Aashish, Sabapathy S Raja
Plastic Surgery & Trauma Reconstructive Surgery, Ganga Hospitals, Coimbatore, India.
J Clin Orthop Trauma. 2019 Sep-Oct;10(5):853-861. doi: 10.1016/j.jcot.2019.08.005. Epub 2019 Aug 19.
Flexor tendon injuries have constituted a large portion of the literature in hand surgery over many years. Yet many controversies remain and the techniques of surgery and therapy are still evolving. The anatomical and finer technical considerations involved in treating these injuries have been put forth and discussed in detail including the rehabilitation following the flexor tendon repair. The authors consider, recognition and mastery of these facts form the foundation for a successful flexor tendon repair. The trend is now towards multiple strand core sutures followed by early active mobilization. However, the rehabilitation process appears to be one of the major determinant of the success following a flexor tendon repair. Early mobilization is essential for all the flexor tendon repairs as it is proved to improve the quality of the repaired tendon. The art of achieving the harmony between a stronger repair and unhindered gliding of the repair site through the narrow flexor tendon sheath simultaneously can be mastered with practice added to the knowledge of the basic principles.
多年来,屈肌腱损伤在手部外科文献中占了很大一部分。然而,许多争议仍然存在,手术和治疗技术仍在不断发展。治疗这些损伤所涉及的解剖学和更精细的技术考量已被提出并详细讨论,包括屈肌腱修复后的康复。作者认为,认识并掌握这些要点是屈肌腱修复成功的基础。目前的趋势是采用多股核心缝合,随后进行早期主动活动。然而,康复过程似乎是屈肌腱修复后成功与否的主要决定因素之一。早期活动对所有屈肌腱修复都至关重要,因为已证明它能提高修复肌腱的质量。通过实践并结合基本原则的知识,可以掌握在进行更牢固的修复与使修复部位在狭窄的屈肌腱腱鞘内不受阻碍地滑动之间实现平衡的技巧。