Kaltenecker G, Wöhry G, Bockhorn G
Universitätsklinik für Unfallchirurgie in Wien.
Handchir Mikrochir Plast Chir. 1996 Jul;28(4):187-90.
The authors present first results after secondary two-stage flexor-tendon reconstruction and a modified postoperative management according to Kleinert. Between 1990 and 1993 we treated eight men and two women with an average age of 35 (19 to 58) years. All injuries were in zone 2. We used the silastic rod (5 mm) as an active gliding prosthesis in stage I. All patients received a palmaris tendon graft in stage II. The patients were treated with a modified Kleinert splinting technique inactivating the palmar traction, employing extension by a rubber band during the night after the second week. We had no complications during the whole treatment phase, no rupture of the tendon grafts and no infection. In our functional results, we saw in one case a lack of PIP-joint flexion of 10 degrees and in another an extension deficit of 15 degrees in the DIP-joint. With this modified technique we achieved satisfying results especially in otherwise non cooperative patients.
作者展示了二期两阶段屈肌腱重建术后的初步结果以及根据克莱纳特方法改良的术后处理措施。1990年至1993年间,我们治疗了8名男性和2名女性,平均年龄35岁(19至58岁)。所有损伤均位于2区。在第一阶段,我们使用5毫米的硅橡胶棒作为主动滑动假体。所有患者在第二阶段均接受掌长肌腱移植。患者采用改良的克莱纳特夹板固定技术,消除掌侧牵引,在第二周后的夜间用橡皮筋进行伸展。在整个治疗阶段,我们没有出现并发症,没有肌腱移植断裂,也没有感染。在功能结果方面,我们发现1例患者近端指间关节屈曲缺失10度,另1例患者远端指间关节伸展缺失15度。通过这种改良技术,我们取得了令人满意的结果,尤其是对于原本不配合的患者。