Sanganboina Spurthi, Hareesh G S R, Jasti Lakshmi Meena, G Purushotham
Department of Plastic Surgery, Government Medical College, Ongole, IND.
Department of General Surgery, Government Medical College, Ongole, IND.
Cureus. 2024 Jul 27;16(7):e65486. doi: 10.7759/cureus.65486. eCollection 2024 Jul.
Introduction The important factors determining the treatment of extensor tendon injuries include the anatomical zone, type of injury, mode of injury, chronicity, and pathology of the adjacent tissues (principally the skin, bone, and joints). Very few studies have collectively studied the outcomes of all the wrist, forearm, and hand extensors. Hence, the major aim of this study was to evaluate the results of extensor tendon injuries of the hand, wrist, and forearm that were treated surgically. Methodology This was a hospital-based retrospective study done in a tertiary teaching hospital in South India. A total of 30 patients (23 males, seven females) were included in the study. All the cases of extended tendon injuries of the wrist, hand, and forearm were treated surgically, and those willing to participate were included in the study after obtaining institutional ethics committee approval. Results The study included 30 patients, predominantly males (76.66%). The majority were aged 31-40 years (33.33%). Occupational injuries were the most common cause (36.66%), followed by road traffic accidents (RTAs) and glass cuts (26.66%). Right-sided injuries were more frequent (56.66%), with zone VI being the most affected (43.33%). Extensor digitorum communis was the most injured tendon (40%). Various suture techniques were used, including horizontal mattress and modified Kessler's. Complications occurred in four patients, including hematoma and surgical site infections. Functional outcomes, assessed by Miller's Criteria, indicated extension lag and flexion loss as key recovery measures. Conclusion Hand function is essential for daily life activities, and optimal repair and reconstruction of extensor tendon injuries are crucial to avoid functional disability. While the present study demonstrated positive outcomes, further research with larger sample sizes and more rigorous designs is needed to validate these findings and improve treatment strategies for hand injuries.
决定伸肌腱损伤治疗方案的重要因素包括解剖区域、损伤类型、损伤方式、损伤时间以及相邻组织(主要是皮肤、骨骼和关节)的病理状况。极少有研究综合探讨所有腕部、前臂和手部伸肌损伤的治疗结果。因此,本研究的主要目的是评估手术治疗的手部、腕部和前臂伸肌腱损伤的结果。
这是一项在印度南部一家三级教学医院开展的基于医院的回顾性研究。共有30例患者(23例男性,7例女性)纳入研究。所有腕部、手部和前臂伸肌腱损伤病例均接受手术治疗,在获得机构伦理委员会批准后,愿意参与的患者被纳入研究。
该研究纳入30例患者,以男性为主(76.66%)。大多数患者年龄在31 - 40岁之间(33.33%)。职业损伤是最常见的原因(36.66%),其次是道路交通事故(RTA)和玻璃割伤(26.66%)。右侧损伤更为常见(56.66%),其中VI区受影响最大(43.33%)。指总伸肌是最常受伤的肌腱(40%)。采用了多种缝合技术,包括水平褥式缝合和改良凯斯勒缝合。4例患者出现并发症,包括血肿和手术部位感染。根据米勒标准评估的功能结果表明,伸展滞后和屈曲丧失是关键的恢复指标。
手部功能对于日常生活活动至关重要,伸肌腱损伤的最佳修复和重建对于避免功能残疾至关重要。虽然本研究显示了积极的结果,但需要进行更大样本量和更严谨设计的进一步研究,以验证这些发现并改进手部损伤的治疗策略。