Naam N H
Southern Illinois Hand Center, Effingham 62401, USA.
J Hand Surg Am. 1995 May;20(3):478-83. doi: 10.1016/S0363-5023(05)80111-X.
Spontaneous flexor tendon ruptures are rare. Thirteen patients who had spontaneous intratendinous rupture of the flexor digitorum profundus tendon are described. Twelve of the ruptures occurred in zone III at the level of the lumbrical origin, and one occurred in zone II distal to the A2 pulley. All patients were involved in an activity that required flexion against resistance. Time from injury to treatment averaged 5 weeks. Surgical exploration and subsequent histologic evaluation did not show any pathologic condition to explain the rupture. Surgical treatment was dependent primarily on time from rupture and on the location of the injury; seven patients had direct repair, five had tendon grafting, and one was treated with tendon transfer. Postoperative follow-up time averaged 36 months. All patients regained good-to-excellent active range of motion and returned to work. Patients who had early direct repair of the tendon had better functional results than those who were treated with tendon grafting or tendon transfer.
自发性屈指肌腱断裂较为罕见。本文描述了13例指深屈肌腱自发性腱内断裂的患者。其中12例断裂发生在Ⅲ区蚓状肌起点水平，1例发生在Ⅱ区A2滑车远端。所有患者均参与了需要抗阻力屈曲的活动。从受伤到治疗的平均时间为5周。手术探查及后续组织学评估未发现任何可解释断裂的病理状况。手术治疗主要取决于断裂时间和损伤部位；7例患者进行了直接修复，5例进行了肌腱移植，1例接受了肌腱转位治疗。术后平均随访时间为36个月。所有患者均恢复了良好至优秀的主动活动范围并重返工作岗位。早期直接修复肌腱的患者比接受肌腱移植或肌腱转位治疗的患者功能恢复更好。
