Chan Peter Y W, Green Anna, Fried Alta, Chao John A, Moore Caroline, Shah Ajul
The Institute for Advanced Reconstruction, Shrewsbury, NJ.
Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.
J Hand Surg Glob Online. 2022 Oct 28;5(2):215-218. doi: 10.1016/j.jhsg.2022.09.006. eCollection 2023 Mar.
Rupture is a major concern after primary flexor tendon repair. The predominant treatment for rupture of the primary repair is immediate surgical exploration and repeat repair. However, repeat repair is challenging, including achieving ideal tension in the flexor mechanism. Further, immediate repeat repair is associated with poor outcomes, particularly in the small finger. As such, there is a need to improve both the technique and outcomes of repeat repair of primary flexor tendon rupture. We present a case of primary flexor tendon repair rupture treated with a novel combination of fractional tendon lengthening and the wide awake, local anesthesia, no tourniquet technique. A combination of these techniques has multiple benefits. An intraoperative, dynamic assessment of the digits enables immediate optimization of the repair. Further, these techniques allow for better intraoperative patient education and communication, increasing the likelihood of adherence to postoperative therapy and better overall outcomes.
屈指肌腱一期修复术后的肌腱断裂是一个主要问题。一期修复肌腱断裂的主要治疗方法是立即进行手术探查和再次修复。然而，再次修复具有挑战性，包括在屈肌装置中达到理想的张力。此外，立即再次修复的效果不佳，尤其是在小指。因此，有必要改进一期屈指肌腱断裂再次修复的技术和效果。我们报告一例一期屈指肌腱修复断裂的病例，采用了一种新颖的组合方法，即部分肌腱延长术与清醒局部麻醉、不使用止血带技术相结合。这些技术的组合有多种益处。术中对手指进行动态评估可立即优化修复效果。此外，这些技术能在术中更好地对患者进行教育和沟通，增加患者坚持术后治疗的可能性，并改善总体效果。
