Xiao Gong, Wang Jinzhong, Zhang Ningjie, Hao Juanjuan
Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing, Zhejiang, China.
School of Medicine, Shaoxing University, Shaoxing, China.
Front Surg. 2024 May 1;11:1304202. doi: 10.3389/fsurg.2024.1304202. eCollection 2024.
Extensor tendon adhesion receive less attention recently. This study aims to analyze influencing factors of adhesion and prolonged lost days of work in patients with extensor tendon adhesion of the hand.
We performed a retrospective study in patients with extensor tendon injuries who underwent primary surgical repair and early rehabilitation. We observed the differences between non-tendon adhesion and adhesion patients after surgical repair, and used the receiver operating characteristic curve to distinguish them. Then we explored the influencing factors of adhesion. In addition, we studied the lost days of work and the influencing factors.
A total of 305 patients were included. 24.6% patients appeared tendon adhesion and the mean lost days of work was 12 weeks. MHISS scores, VAS scores, occupation and blood triglyceride level were the influencing factors of adhesion. The adhesion patients have increased MHISS scores ( < 0.001), VAS scores ( < 0.001), blood triglyceride levels ( < 0.001) and lost days of work ( < 0.001) than non-tendon adhesion. The optimal cut-off value of blood triglyceride level to distinguish non-tendon adhesion from adhesion was 1.625 mml/L, and MHISS scores was 20.5. Smoking, MHISS scores, blood triglyceride levels were the influencing factors of lost days of work in adhesion patients. There was positive correlation between lost days of work and triglyceride level ( = 0.307, = 0.007), and MHISS scores ( = 0.276, = 0.016).
To minimize the occurrence of adhesion, doctors should pay attention to patients with higher MHISS and VAS scores, blood triglyceride levels, especial for the blue-collar and unemployed one. High triglyceride level may be a new influencing factor.
伸肌腱粘连近来受到的关注较少。本研究旨在分析手部伸肌腱粘连患者粘连的影响因素以及工作损失天数延长的情况。
我们对接受一期手术修复和早期康复的伸肌腱损伤患者进行了一项回顾性研究。我们观察了手术修复后无肌腱粘连患者与粘连患者之间的差异，并使用受试者工作特征曲线对其进行区分。然后我们探讨了粘连的影响因素。此外，我们研究了工作损失天数及其影响因素。
共纳入305例患者。24.6%的患者出现肌腱粘连，平均工作损失天数为12周。MHISS评分、VAS评分、职业和血甘油三酯水平是粘连的影响因素。与无肌腱粘连患者相比，粘连患者的MHISS评分（<0.001）、VAS评分（<0.001）、血甘油三酯水平（<0.001）和工作损失天数（<0.001）均有所增加。区分无肌腱粘连与粘连的血甘油三酯水平的最佳截断值为1.625 mmol/L，MHISS评分为20.5。吸烟、MHISS评分、血甘油三酯水平是粘连患者工作损失天数的影响因素。工作损失天数与甘油三酯水平（r=0.307，P=0.007）和MHISS评分（r=0.276，P=0.016）呈正相关。
为尽量减少粘连的发生，医生应关注MHISS和VAS评分较高、血甘油三酯水平较高的患者，尤其是蓝领和无业患者。高甘油三酯水平可能是一个新的影响因素。
