Department of Orthopedics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.
Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, MA, USA.
Iowa Orthop J. 2021 Dec;41(2):95-100.
Various surgical techniques for treating avulsions of the flexor digitorum profundus tendon at the distal phalanx have been published but no ideal technique has emerged. We introduce a new all-internal 4-anchor flexor tendon repair technique and evaluate outcomes in three clinical cases.
In this retrospective case series, we reviewed three patients that sustained an avulsion of the flexor digitorum profundus tendon at the distal phalanx. All patients were surgically treated with the four-anchor repair technique. Two titanium anchors were inserted into the distal phalanx and two all-suture anchors were inserted distal to the first set of anchors. The tendon was then attached to these four anchors using a Krackow stitch pattern and the anchors were sown to each other. Active flexion and extension of the proximal and distal interphalangeal joint were measured at 3-month, 12-month, and 5-year follow-up. Postoperative complications were documented.
All patients achieved excellent clinical outcomes according to assessment criteria. At 3-month follow-up, all patients regained full flexion; two patients had full extension, while one patient was 3 degrees short of full extension. At 12-month follow-up, all patients had full flexion and extension. Five-year follow-up demonstrated the same results with no loss of function, sensation or grip strength. The repairs healed without rupture, and no complications were reported.
The 4-anchor flexor tendon repair is a viable surgical technique for zone 1 flexor digitorum profundus tendon repair or reconstruction. Further studies are needed to replicate these promising results and biomechanically validate this technique. IV.
已经发表了多种治疗远节指骨屈肌腱止点撕脱伤的手术技术，但尚未出现理想的技术。我们介绍一种新的四锚点屈肌腱修复技术，并通过三个临床病例评估结果。
在这项回顾性病例系列研究中，我们回顾了 3 例远节指骨屈肌腱止点撕脱伤的患者。所有患者均接受四锚点修复技术治疗。将两个钛锚钉插入远节指骨，两个全缝线锚钉插入第一组锚钉下方。然后，使用 Krackow 缝合模式将肌腱固定在这四个锚钉上，并将锚钉相互缝合。在 3 个月、12 个月和 5 年随访时测量近节指间关节和远节指间关节的主动屈伸活动度。记录术后并发症。
根据评估标准，所有患者均获得了优异的临床结果。在 3 个月随访时，所有患者均恢复了完全屈曲；2 例患者完全伸展，1 例患者伸展度差 3 度。在 12 个月随访时，所有患者均有完全的屈伸活动度。5 年随访结果相同，无功能、感觉或握持力丧失。修复体愈合无断裂，无并发症报告。
四锚点屈肌腱修复是治疗 1 区屈肌腱修复或重建的可行手术技术。需要进一步的研究来复制这些有前途的结果，并对该技术进行生物力学验证。
