Radiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Radiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Ultrasound Med Biol. 2021 Aug;47(8):2157-2166. doi: 10.1016/j.ultrasmedbio.2021.02.023. Epub 2021 Apr 29.
This study was aimed at validating the diagnostic accuracy of ultrasound (US) scans in pre-operative evaluation of flexor tendon injuries in the hand and to determine its value in the management of such injuries and in the prediction of patient outcome. This descriptive cross-sectional prospective study included 35 patients with penetrating trauma to the volar aspect of the hand or wrist with questionable clinical findings. They had 50 injured tendons and were candidates for exploratory surgery versus physiotherapy. They underwent pre-operative US to guide their management. Ultrasound results were compared with the operative findings as the gold standard test. Patients were followed up postoperatively, and functional outcome was assessed and correlated with pre-operative sonographic findings. Our results indicate that sonographic examination of hand tendon injury has high accuracy in diagnosing complete or partial flexor injuries, with 100% accuracy, sensitivity and specificity in diagnosing full-thickness tears as well as tenosynovitis of hand flexor tendons. Zonal II injury was the most frequent among our study population and correlated with poorest functional outcome after rehabilitation at 3 mo follow-up. US of the hand is a fast, inexpensive and potentially indispensable dynamic tool for accurate assessment of flexor tendon injuries. It provides data on the extent of injury that effectively helps both set up an appropriate operative plan and predict the patient's functional outcome post-operatively, which in turn will have a direct impact on the patient's rehabilitation plan and lifestyle. Thus, it should be a fundamental part of the management of patients with tendon injuries.
本研究旨在验证超声（US）扫描在手部屈肌腱损伤术前评估中的诊断准确性，并确定其在手屈肌腱损伤管理中的价值以及对患者预后的预测价值。这项描述性的前瞻性研究共纳入 35 例手部掌侧或腕部穿透性创伤患者，这些患者临床检查结果可疑。他们共有 50 个受伤的肌腱，适合进行探查手术或物理治疗。所有患者均在术前进行超声检查，以指导治疗。将超声结果与手术结果进行比较，作为金标准检测。术后对患者进行随访，评估功能结果，并与术前超声检查结果相关联。我们的研究结果表明，手部肌腱损伤的超声检查在诊断完全或部分屈肌腱损伤方面具有很高的准确性，对全层撕裂和手部屈肌腱腱鞘炎的诊断准确率、灵敏度和特异性均为 100%。在我们的研究人群中，II 区损伤最为常见，与 3 个月随访时康复后的最差功能结果相关。手部超声检查是一种快速、廉价且具有潜在不可或缺性的动态工具，可准确评估屈肌腱损伤。它提供了有关损伤程度的信息，这对于制定合适的手术计划和预测患者术后功能结果都非常有帮助，进而直接影响患者的康复计划和生活方式。因此，它应该成为肌腱损伤患者管理的基本组成部分。
