Oeckenpöhler Simon, Langer Martin Franz, Aitzetmüller-Klietz Matthias Michael, Aitzetmüller-Klietz Marie-Luise, Nottberg Valerie, Riesenbeck Oliver
Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Waldeyer Str. 1, 48149 Münster, Germany.
Section for Plastic and Reconstructive Surgery, Department of Traumatology, University Hospital Münster, Waldeyer Str. 1, 48149 Münster, Germany.
J Clin Med. 2023 Aug 7;12(15):5154. doi: 10.3390/jcm12155154.
Twenty-three patients with a mean age of 52.7 years underwent pulley reconstruction using the Okutsu double- or triple-loop technique after iatrogenic or traumatic rupture of at least two adjacent flexor tendon pulleys in the finger and distal palm; mean age of injury was 4.77 years. The mean follow-up was 4.66 years after reconstruction of mostly A2 pulleys in a single surgeon setting. Outcome measures included ROM, NRS pain, satisfaction, Disabilities of Arm, Shoulder and Hand Questionnaire (DASH) and Krimmer score, Buck-Gramcko score, Jamar grip strength, pinch grip, and vigorimetry compared to the uninjured side. The median patient satisfaction score was 6.6/10. Hand function using the DASH score was 9.5. Grip strength on the Jamar Dynamometer showed only a slight reduction of 13% compared to the uninjured side. The resultant force of the operated fingers on the vigorimeter is almost 60% of that of the contralateral side, and the finger-palm distance of the operated finger was reduced from 2.2 cm to 1.45 cm. Other functional scores, such as Krimmer (82.2) and Buck-Gramcko (10.9), support these good results. The follow-up of patients more than 4.5 years after reconstruction of the A2 and A3 flexor tendon pulley using the double- or triple-loop technique showed acceptable patient satisfaction and good function of the finger in everyday life.
23例平均年龄52.7岁的患者，在手指和手掌远端至少两根相邻屈肌腱滑车发生医源性或外伤性断裂后，采用奥utsu双环或三环技术进行滑车重建；受伤平均年龄为4.77岁。在单一外科医生的情况下，对主要为A2滑车进行重建后，平均随访时间为4.66年。结果指标包括活动度（ROM）、数字评定量表（NRS）疼痛评分、满意度、手臂、肩部和手部功能障碍问卷（DASH）、克里默评分、巴克-格拉姆科评分、贾马尔握力、捏力和力量测定，并与未受伤侧进行比较。患者满意度中位数评分为6.6/10。使用DASH评分的手部功能评分为9.5。与未受伤侧相比，贾马尔测力计上的握力仅略有下降，为13%。操作手指在力量测定仪上的合力几乎是对侧的60%，操作手指的指掌距离从2.2厘米减少到1.45厘米。其他功能评分，如克里默评分（82.2）和巴克-格拉姆科评分（10.9），也支持这些良好结果。对采用双环或三环技术重建A2和A3屈肌腱滑车4.5年以上的患者进行随访，结果显示患者满意度可接受，手指在日常生活中的功能良好。
