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腕掌部浅腱段带蒂滑行移植修复鞘内深腱缺损的研究

Study on Sliding Graft of Wrist Palmar FDS with Pedicle of Injured Finger Repairing the Defect of Zone Ⅱ Flexor Tendon

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【作者】 张树桧李同森李亚平时宏富郭漳生郑召民马希峰陈清汉

【Author】 Zhang Shu-hui, Li Tong-sen, Li Ya-ping, et al. Dept.of Orthopedics,2nd Affliliated Hospital, Henan Medical Universily, Zhengzhou 450003

【机构】 郑州河南医科大学第二附属医院

【摘要】 为了给临床修复深腱缺损提供一种带血供的滑膜腱移植体和方法,参考了国内外文献,进行了动物实验和前臂、腕掌部浅腱血液供应的解剖学研究,设计出利用腕掌部浅腱段滑行移植的手术方法,尸体和临床验证结果合理、可行。7例9指的修复效果满意,优良率达90%。其操作要点为:臂丛阻滞麻醉下,在止血带和手术显微镜下操作。Brunner切口,合页式切开腱鞘,切除浅腱远端,修剪深腱远端及浅腱近端,测量深腱远端和浅腱近端间的距离,即深腱缺损长度。根据缺损长度,在前臂适当部位切断伤指浅腱形成腕掌部浅腱段,轻轻向远侧牵拉其远端,利用腱系膜的可伸展性,使该腱段向前滑行与深腱远端进行改良Kessler吻合,修复健鞘,缝合手指和掌部切口。在前臂行掌长腱移位与浅腱段近端行编织吻合。关闭前臂切口,背侧石膏托固定于腕屈位,橡皮筋牵引患指。术后第7天开始主动伸指、被动屈指训练,4周后拆除固定自由活动,辅以理疗、热水浴等治疗。该法适合于早、晚期修复,创伤小,一次完成,操作简便实用,便于推广。

【Abstract】 In order to provide a method and donor of synovial sheath tendon with blood pedicle to repair the defect of filexor digitorumprofoundus (FDP), we reviewed references at home and abroad, and carried out dnimal experiments and anatomic studies of flexordigitorum superficialis (FDS), blood supply at forearm and wrist and designed an operation method to achieve sliding grafts of FDSof wrist and palms. The operation method proved to be reasonable based on corpse experiment and clinical application. The resultsof 9 fingers of 7 cases were satisfactory. the excellent or good rate was 90%. This method is suitable to the primary and delayed re-pair of the injured tendon and the repair can be finished just one time. It is simple. applicable, and easy to be mastered, and causessmall scope of wound.

  • 【文献出处】 中华创伤杂志 ,CHINESE JOURNAL OF TRAUMATOLOGY , 编辑部邮箱 ,1994年06期
  • 【分类号】R686.105
  • 【下载频次】20
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