Grobbelaar A O, Hudson D A
Hand Unit, University of Cape Town, South Africa.
J Hand Surg Br. 1994 Dec;19(6):696-8. doi: 10.1016/0266-7681(94)90237-2.
Flexor tendon injuries in adults differ from those in children. 38 children (22 male and 16 female) with a mean age of 6.7 years were treated for flexor tendon injuries by primary suture and controlled mobilization between 1985 and 1992. 53 flexor tendons were injured (average 1.5 digits per patient) and the injury most commonly affected the little finger (23 patients). 60% of injuries occurred in zone 2. Using Lister's criteria, 82% achieved excellent or good results. Repair of both FDS and FDP was better than repair of FDP alone, even in zone 2. There were three tendon ruptures (all classified as poor results) and one other poor result occurred in a zone 2 injury with an associated ulnar nerve palsy. The outcome after flexor tendon repair in children is better than in adults in our hands because rapid healing of tendons occurs in children. No child has yet required tenolysis because in children adhesions are more pliable. Both flexor tendons should be repaired irrespective of the zone of injury. A functional hand can be expected after flexor tendon repair in children.
成人屈指肌腱损伤与儿童不同。1985年至1992年间，38名平均年龄为6.7岁的儿童（22名男性和16名女性）因屈指肌腱损伤接受了一期缝合和控制性活动治疗。53条屈指肌腱受伤（平均每位患者1.5个手指），损伤最常累及小指（23例患者）。60%的损伤发生在2区。根据利斯特标准，82%的患者获得了优或良的结果。即使在2区，同时修复指浅屈肌腱（FDS）和指深屈肌腱（FDP）也比单独修复FDP效果更好。有3例肌腱断裂（均归类为差的结果），另1例差的结果发生在伴有尺神经麻痹的2区损伤中。在我们的治疗中，儿童屈指肌腱修复后的结果优于成人，因为儿童肌腱愈合迅速。尚无儿童需要进行肌腱松解术，因为儿童的粘连更易松动。无论损伤位于哪个区域，两条屈指肌腱均应修复。儿童屈指肌腱修复后有望获得功能良好的手。
