Department of Hand Surgery, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland.
Department of Hand Surgery, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland.
Hand Surg Rehabil. 2021 Jun;40(3):224-230. doi: 10.1016/j.hansur.2021.01.001. Epub 2021 Jan 14.
The choice of the donor tendon in tendon reconstruction of the hand theoretically influences the results of the surgery because of the interactions of its structure with the healing process. The objective of our study was to specify the surgical bases of vascularized extensor indicis proprius (EIP) in tendon reconstruction of the hand and to present its application from a series of observations. According to our observations, the EIP's vascularization arises from a branch of the 2nd dorsal metacarpal artery, 3-4 cm proximally to the metacarpophalangeal joint (MCP). We demonstrate the feasibility and effectiveness of a vascularized EIP graft for finger flexor tendon reconstruction, for defects of the extensor mechanism at the MCP joint level and for reconstruction of the extensor pollicis longus. Our biomimetic approach in tendon reconstruction has led us to factor in the complexity of the tendon and peritendinous structure. The use of vascularized EIP offers theoretical advantages for the tendon healing process, demonstrates encouraging first results with interesting versatility and very low iatrogenicity.
在手的肌腱重建中，供体肌腱的选择理论上会影响手术结果，因为其结构与愈合过程相互作用。我们的研究目的是明确血管化固有伸指肌腱（EIP）在手肌腱重建中的手术基础，并从一系列观察中介绍其应用。根据我们的观察，EIP 的血管化源自第二背侧掌骨动脉的分支，在掌指关节（MCP）近端 3-4cm 处。我们证明了血管化 EIP 移植物在手屈肌腱重建、MCP 关节水平伸肌机制缺损和拇长展肌重建中的可行性和有效性。我们在手肌腱重建中的仿生方法促使我们考虑到肌腱和腱周结构的复杂性。血管化 EIP 的使用为肌腱愈合过程提供了理论优势，具有令人鼓舞的初步结果，具有有趣的多功能性和非常低的医源性。
