Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Southmead Hospital, Westbury-on-Trym, Bristol, UK.
Physiotherapy Department, English Institute of Sport, Sheffield, UK.
J Hand Surg Eur Vol. 2022 Dec;47(11):1162-1167. doi: 10.1177/17531934221123139. Epub 2022 Sep 15.
We describe our experience of managing extensor hood injuries in boxers (57 fingers). The diagnosis was mostly clinical, with imaging only if the diagnosis was equivocal. The middle (61%) and index (26%) digits were most frequently injured. On exploration, 26% had no hood tear, however all required tenolysis from the adherent capsule. Of 42 hood tears, 15 were central splits between adjacent extensor tendons in the index or little fingers,15 tears were on the ulna side of the extensor tendon and 12 tears were on the radial side. A pseudobursa was encountered in 35%, capsular tears in 28% and chondral injury in one patient. Longitudinal curved metacarpophalangeal joint incisions were used, with hood repair performed in flexion using a locked running suture. Mean postoperative metacarpophalangeal joint flexion was 90°. Ninety-eight per cent returned to the same level of boxing at a mean of 8 months (range 1-24) from surgery. One finger was revised for re-rupture 6 months later. A reproducible technique for treating these injuries is described, with patients able to return to boxing with little risk of complications. IV.
我们描述了我们在处理拳击手（57 个手指）伸肌袖损伤方面的经验。诊断主要是临床的，如果诊断不明确则进行影像学检查。中指（61%）和食指（26%）最常受伤。在探查时，26%的患者没有伸肌袖撕裂，但所有患者均需要从粘连的囊上进行松解。42 个伸肌袖撕裂中，15 个位于食指或小指相邻伸肌腱之间的中央裂，15 个位于伸肌腱的尺侧，12 个位于桡侧。35%的患者发现假性滑囊，28%的患者发现囊撕裂，1 名患者发生软骨损伤。采用纵向弯曲的掌指关节切口，用锁定的连续缝线在屈曲位修复伸肌袖。术后掌指关节屈曲的平均角度为 90°。98%的患者在术后 8 个月（1-24 个月）平均时间内回到相同的拳击水平。1 个手指因 6 个月后再次撕裂而接受了翻修。描述了一种可重复的治疗这些损伤的技术，患者能够以较小的并发症风险重返拳击运动。IV。
