Desai Bhumit, Sumarriva Gonzalo, Dunbar Ross
Department of Orthopedic Surgery, Ochsner Clinic Foundation, New Orleans, LA.
The University of Queensland Faculty of Medicine, Ochsner Clinical School, New Orleans, LA.
Ochsner J. 2021 Spring;21(1):99-103. doi: 10.31486/toj.19.0109.
Multiple closed spontaneous pulley ruptures are rare injuries and require surgical reconstruction to prevent functional deficits. Pulley rupture combined with avulsion of the flexor digitorum superficialis (FDS) tendon is an even more uncommon occurrence. We describe a closed traumatic annular 2 (A2) through annular 4 (A4) pulley rupture with avulsion of the FDS tendon. This uniquely associated pathology was treated with a complex surgical reconstruction that corrected flexion contracture and tendon bowstringing in the left long finger. The desired outcome was achieved through A2 and A4 pulley reconstruction using an autologous palmaris longus tendon graft with FDS tendon excision and proximal interphalangeal joint capsulotomy. Multiple pulley rupture is not commonly combined with FDS avulsion, and treatment of this injury requires careful surgical planning based on pulley biomechanics to maximize postoperative function.
多发性闭合性自发性滑车破裂是罕见的损伤，需要手术重建以防止功能缺陷。滑车破裂合并指浅屈肌腱（FDS）撕脱则更为少见。我们描述了一例闭合性创伤性2区（A2）至4区（A4）滑车破裂合并FDS肌腱撕脱的病例。这种独特的相关病理情况通过复杂的手术重建进行治疗，纠正了左手环指的屈曲挛缩和肌腱弓弦状畸形。通过使用自体掌长肌腱移植进行A2和A4滑车重建、FDS肌腱切除以及近端指间关节囊切开术，实现了预期的治疗效果。多发性滑车破裂通常不合并FDS撕脱，对此类损伤的治疗需要基于滑车生物力学进行仔细的手术规划，以最大限度地提高术后功能。
