Aulicino P L
Eastern Virginia Graduate School of Medicine, Norfolk, USA.
Hand Clin. 1995 Aug;11(3):403-10.
The results of acute repair of the extensor tendons proximal to the metacarpophalangeal joint vary with the degree of associated injuries. Shortening should be kept to a minimum at the time of repair. The Kleinert modification of the Bunnell technique affords the greatest tensile strength. A 3-0 or 4-0 nonabsorbable suture on a small tapered needle should be used. The extensor retinaculum should be resected or transposed for injuries in zones VII and T V. Sensory branches of the ulnar and radial nerves should be repaired primarily, if possible. The most frequent complication is loss of metacarpophalangeal joint flexion secondary to tendon adhesions. The more complex the wound, the greater the indication for controlled mobilization.
掌指关节近端伸肌腱急性修复的结果因相关损伤的程度而异。修复时应将缩短控制在最小程度。Bunnell技术的Kleinert改良法能提供最大的抗张强度。应使用带小锥形针的3-0或4-0不可吸收缝线。对于Ⅶ区和Ⅴ区的损伤，应切除或移位伸肌支持带。如有可能，尺神经和桡神经的感觉支应一期修复。最常见的并发症是因肌腱粘连导致掌指关节屈曲丧失。伤口越复杂，控制活动的指征就越强。
