Hill B B, Wells M D, Prevel C D
Department of Surgery, UK Chandler Medical Center, Lexington, KY, USA.
Ann Plast Surg. 1997 May;38(5):446-8. doi: 10.1097/00000637-199705000-00002.
Retrieval of retracted zone 1, 2, and 3 flexor tendons without a proximal incision can occasionally lead to excessive tendon trauma or injury to neurovascular structures. To determine if endoscopic flexor tendon retrieval is a reliable, reproducible technique, 34 zone 2 flexor tendon lacerations were created in four cadaveric hands (2 male; 2 female). The tendons were retracted proximally an average of 4.3 +/- 1.9 cm (range, 2-10 cm) through a separate transverse wrist incision. A 2.5-mm flexible endoscope was introduced into the distal tendon sheath, and all transected tendons (N = 34) were clearly visualized. Thirty-two tendons (94%) were retrieved endoscopically by using either a loop snare or grasping forceps. Two tendons (6%) in a small female hand could not be retrieved endoscopically. This minimally invasive technique may be an alternative to the blind grasping maneuvers, proximal incision extensions, and counter-incisions in the palm.
在不做近端切口的情况下，对回缩至1区、2区和3区的屈肌腱进行取腱，偶尔会导致过度的肌腱损伤或神经血管结构损伤。为了确定内镜下屈肌腱取腱术是否是一种可靠、可重复的技术，在4具尸体手（2男；2女）上制造了34处2区屈肌腱撕裂伤。通过一个单独的腕部横向切口，将肌腱平均向近端回缩4.3±1.9厘米（范围2 - 10厘米）。将一根2.5毫米的软性内窥镜插入远端腱鞘，所有横断的肌腱（N = 34）都能清晰可见。使用圈套器或抓钳，通过内镜取出了32根肌腱（94%）。在一名瘦小女性的手上，有两根肌腱（6%）无法通过内镜取出。这种微创技术可能是盲目抓取操作、延长近端切口和在手掌做对口切口的替代方法。
