Miguleva I Iu
Khirurgiia (Mosk). 1996(2):92-6.
From experience in the treatment of more than 800 patients by various methods of autotendoplasty which had been developed in the clinic earlier, the authors analysed the most characteristic complications of these operations. Separation of the wound edges and partial marginal necroses of the skin occurred in 7-8% of patients, mainly in bilateral damage to the neurovascular bundles of the fingers, ligature fistulas in 6-7%, ruptures in 5%, flexion contractures of the fingers formed in 2% of patients who had been operated on, suppuration of the wounds was practically not encountered. The peculiarities of surgical sanative procedures for ligature fistulas depending on their localization are described. The operative tactics in rupture of the tendon sutures after tendoplasty was elaborated: immediate repeated autoplasty is recommended in late-term ruptures, whereas in early ruptures the best results are produced by two-stage tendoplasty with temporary endoprosthetics of the tendon with silicone no earlier than 2-3 months after the rupture. The authors discuss the method for treatment of formed flexion contractures of the fingers by means of a distraction apparatus at a slow distraction mode, which produces good functional results.
根据该诊所此前研发的多种自体肌腱成形术治疗800余例患者的经验，作者分析了这些手术最典型的并发症。7-8%的患者出现伤口边缘分离和皮肤部分边缘坏死，主要发生在手指神经血管束双侧损伤时；6-7%的患者出现结扎瘘；5%的患者出现破裂；2%接受手术的患者形成手指屈曲挛缩，伤口化脓实际未出现。描述了根据结扎瘘位置不同的外科治疗方法特点。阐述了肌腱成形术后肌腱缝合处破裂的手术策略：晚期破裂建议立即再次自体成形术，而早期破裂在破裂后不早于2-3个月采用带硅胶临时肌腱假体的两阶段肌腱成形术可取得最佳效果。作者讨论了通过缓慢牵引模式的牵引装置治疗已形成的手指屈曲挛缩的方法，该方法可产生良好的功能效果。
