Kleinert H E, Lubahn J D
Ann Chir Main. 1984;3(1):7-17. doi: 10.1016/s0753-9053(84)80056-3.
Successful restoration of function after flexor tendon injuries continues to present a challenge to the treating surgeon. Primary repair of tendon and associated injuries is the treatment of choice in clean wounds in all zones of the hand. In cases of untidy wounds or when associated injuries preclude primary repair, delayed primary or secondary repair may be performed. Tendon grafting in one or two stages is reserved for late secondary cases in which scarring of the bed, loss of pulleys, permanent retraction of the tendon ends, or joint contractures prevent direct repair. Meticulous attention to detail such as adequate exposure, careful opening and closing of the sheath, gentle handling of the tendons, a secure, smooth tendon juncture and proper postoperative splinting is essential for a successful outcome of direct repair. Tendon grafts done as a secondary procedure require the same attention to minutiae for an adequate functional outcome.
屈指肌腱损伤后功能的成功恢复仍然是治疗外科医生面临的一项挑战。在手部所有区域的清洁伤口中，肌腱及相关损伤的一期修复是首选治疗方法。对于伤口不整齐或存在相关损伤而无法进行一期修复的情况，可进行延迟一期或二期修复。一期或二期肌腱移植仅用于晚期二期病例，即存在床面瘢痕、滑车缺失、肌腱末端永久性回缩或关节挛缩而无法直接修复的情况。对于直接修复的成功结果而言，细致入微地关注细节至关重要，例如充分暴露、小心打开和关闭腱鞘、轻柔处理肌腱、确保牢固、平滑的肌腱连接以及正确的术后夹板固定。作为二期手术进行的肌腱移植，为获得足够的功能结果，同样需要关注这些细微之处。
