Le Nen D, Escobar C, Stindel E, Marchand A C, Le Bigot P, Lefevre C, Courtois B
Service de Chirurgie Orthopédique et Traumatologique, CHRU, Brest.
Rev Chir Orthop Reparatrice Appar Mot. 1993;79(3):194-9.
From January 1988 to May 1991, 30 patients (mean age: 27 years old; range: 15 to 45) sustained 57 tendon injuries in 49 fingers. They were treated by primary repair with assisted post-operative mobilisation by a dynamic splint. Adhesion of extensor apparatus rate was 12 p. cent but only one had a functional impairment. No other complications were noted. At the thumb level (3 out of 49 fingers) the Kapandji-test was respectively at 8.8 and 9/10 without any extensor lack. At the long fingers level TAM was excellent in 91 p. cent of cases, good in 4 p. cent, fair and poor in 2 p. cent. According to Allieu classification results were good and excellent in 9 p. cent of cases. These results were better when injury was localised to or up to zone 5 according to Verdan's classification, and when there was no associated bone nor articular injuries or cutaneous defects. Subjective results were less good (70 p. cent of satisfactory results) because of pain, grip strength lack or disability. Assisted mobilisation allowed intrinsic healing and avoided adhesion when application date and rehabilitation protocol were respected. It was more beneficial for distal and complex injuries.
1988年1月至1991年5月，30例患者（平均年龄：27岁；范围：15至45岁）的49根手指发生了57处肌腱损伤。他们接受了一期修复，并通过动力夹板辅助术后活动。伸肌装置粘连率为12%，但只有1例存在功能障碍。未发现其他并发症。在拇指水平（49根手指中的3根），卡潘迪试验分别为8.8和9/10，无伸肌缺失。在长手指水平，91%的病例总主动活动度（TAM）为优，4%为良，2%为中差。根据阿列尤分类，9%的病例结果为优和良。当损伤根据韦尔丹分类局限于或达到5区，且无相关骨骼、关节损伤或皮肤缺损时，这些结果更好。由于疼痛、握力不足或功能障碍，主观结果较差（满意结果占70%）。当遵循应用日期和康复方案时，辅助活动可实现内在愈合并避免粘连。对于远端和复杂损伤更有益。
