Reill P
Handchir Mikrochir Plast Chir. 1982;14(3):141-52.
The protracted controversy about whether divided tendons, particularly in the so-called no-man's land, should be treated primarily or secondarily, seems to be resolved. Primary tendon suture with immediate dynamic splintage has led to a significant improvement in the results and is preferred, with minor variations, by most hand surgeons. Following a description of flexor tendon anatomy, more recent discoveries about the physiology of tendon healing are discussed. Developing from this, the currently used refined techniques of primary tendon repair are described. Particular attention is given to an exact description of post-operative supervision and management. Immediate tendon repair and subsequent treatment with dynamic splintage after Kleinert have considerable advantages for function, reduction of operating time and reduction of time off work. So-called secondary tendon repair after fresh, clean flexor tendon division should no longer be performed. Referral of patients with flexor tendon injuries, even from considerable distances, appears indicated, not only because of the better results but also for economic reasons. The previously published results are briefly described and critically reviewed.
关于断裂肌腱，特别是在所谓的无人区的肌腱，应一期治疗还是二期治疗的长期争论似乎已经解决。一期肌腱缝合并立即进行动态夹板固定已使治疗结果有了显著改善，并且大多数手外科医生在稍有差异的情况下更倾向于这种方法。在描述了屈肌腱解剖结构之后，讨论了有关肌腱愈合生理学的最新发现。在此基础上，描述了目前使用的精细一期肌腱修复技术。特别关注术后监督和管理的精确描述。Kleinert法的一期肌腱修复及随后的动态夹板治疗在功能、减少手术时间和减少误工时间方面具有相当大的优势。新鲜、清洁的屈肌腱断裂后不应再进行所谓的二期肌腱修复。即使距离较远，也建议将屈肌腱损伤患者转诊，这不仅是因为治疗效果更好，也是出于经济原因。简要描述并批判性地回顾了先前发表的结果。
