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羊膜包裹肌腱对6区伸肌腱修复效果的影响。

Effect of Tendon Wrapping with Amniotic Membrane on Zone 6 Extensor Tendon Repair Outcomes.

作者信息

Hassanpour Seyed Esmail, Yavari Masoud, Moosavizadeh Seyed Mehdi, Rostami Khalil, Layegh Hojjat

机构信息

Department of Plastic Surgery, Panzdahe Khordad Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Hand and Microsurgery, Panzdahe Khordad Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

World J Plast Surg. 2025;14(1):72-78. doi: 10.61186/wjps.14.1.72.

Abstract

BACKGROUND

Extensor tendon repair is prone to adhesion that affects the outcomes of tendon repair surgery and tendon function regain. Prevention of these complications should be considered in tendon rupture treatment. We aimed to evaluate the effect of tendon wrapping with amniotic membrane on the outcomes of extensor tendon repair in zone 6.

METHODS

This randomized controlled clinical trial was conducted on 30 patients with an extensor tendon injury in zone 6 following penetrating trauma to extensor digitorum communis of the third and fourth digits referred to 15 Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran . Patients were randomly assigned into two matched groups based on age and gender. Both groups underwent tendon repair using the modified Kessler method. In the intervention group (n=15), the repair site was wrapped with an amniotic membrane, while the control group underwent the traditional procedure without wrapping. Both groups underwent a similar rehabilitation process. Patients were followed up for 6 months. The QuickDash score, range of motion (ROM), complications, and recovery duration were recorded for patients in both groups.

RESULTS

The patients in the intervention group had a lower QuickDash score (P<0.001), ROM (P<0.001), and shorter recovery duration (P<0.001) compared to the control group. The only complication was a wound infection that was seen in one patient in the control group. There was no evidence of tendon re-rupture and amniotic membrane hypersensitivity among patients.

CONCLUSION

Amniotic, wrapping is an effective method in extensor tendon repair and is associated with better outcomes and faster recovery, suggesting less peritendinous fibrosis.

摘要

背景

伸肌腱修复容易发生粘连,这会影响肌腱修复手术的效果和肌腱功能的恢复。在肌腱断裂治疗中应考虑预防这些并发症。我们旨在评估用羊膜包裹肌腱对6区伸肌腱修复效果的影响。

方法

本随机对照临床试验对30例因第三和第四指伸指总肌穿透伤导致6区伸肌腱损伤的患者进行,这些患者转诊至伊朗德黑兰沙希德·贝赫什提医科大学的15 Khordad医院。根据年龄和性别将患者随机分为两个匹配组。两组均采用改良凯斯勒方法进行肌腱修复。干预组(n = 15)用羊膜包裹修复部位,而对照组采用传统方法不进行包裹。两组都接受了类似的康复过程。对患者进行了6个月的随访。记录两组患者的QuickDash评分、活动范围(ROM)、并发症和恢复持续时间。

结果

与对照组相比,干预组患者的QuickDash评分更低(P < 0.001),ROM更低(P < 0.001),恢复持续时间更短(P < 0.001)。唯一的并发症是对照组有1例患者出现伤口感染。患者中没有肌腱再次断裂和羊膜超敏反应的证据。

结论

羊膜包裹是伸肌腱修复的一种有效方法,与更好的结果和更快的恢复相关,提示腱周纤维化更少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9788/12124268/d75551113d79/wjps-14-072-g001.jpg

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