McCarthy D M, Tramaglini D M, Chan S S, Schmidt C C, Sotereanos D G, Herndon J H
Department of Orthopaedic Surgery, University of Pittsburgh, PA, USA.
J Hand Surg Am. 1995 Sep;20(5):795-800. doi: 10.1016/S0363-5023(05)80434-4.
The appropriate management of partially lacerated digital flexor tendons in zone 2 is controversial. Tenorrhaphy has been advocated by some on the basis of improving tendon gliding function, whereas others have recommended foregoing tenorrhaphy because of the negative impact of repair on the tensile strength of the tendon. In light of this division, we undertook a study of the effect of varying degrees of partial laceration on the structural properties of the canine flexor digitorum profundus tendon. Lacerations up to 90% of the tendon cross-sectional area were surgically fashioned. We conclude that the structural properties of the tendon are increasingly adversely affected as laceration size increases. However, based on previous estimates of in vivo forces, even tendons with up to 60% cross-sectional area involvement may be strong enough to withstand an early active mobilization regimen. Further, we conclude that neither calipers nor naked-eye estimates provide a reliable means of assessing the extent of tendon laceration.
2区部分撕裂的指屈肌腱的恰当处理存在争议。一些人主张进行肌腱缝合术，理由是可改善肌腱滑动功能，而另一些人则建议不进行肌腱缝合术，因为修复会对肌腱的抗张强度产生负面影响。鉴于这种分歧，我们开展了一项研究，探讨不同程度的部分撕裂对犬趾深屈肌腱结构特性的影响。通过手术制造出高达肌腱横截面积90%的撕裂伤。我们得出结论，随着撕裂伤尺寸的增加，肌腱的结构特性受到的不利影响越来越大。然而，根据先前对体内力的估计，即使横截面积受累达60%的肌腱也可能足够强壮，能够承受早期主动活动方案。此外，我们得出结论，卡尺测量和肉眼估计都无法提供评估肌腱撕裂程度的可靠方法。
