汤锦波 谢仁国 侍德 226001 南通医学院附属医院手外科 中华手外科杂志 1999 0 15 4


    关键词：腱损伤；移植；自体；显微外科手术；治疗结果 期刊 zhswkzz 0 肌腱外科 fur -->


    

【摘要】 目的 探索自体腱鞘移植在屈肌腱伴腱周组织严重损伤时，重建指屈肌腱背侧或环周腱鞘缺损的方法和效果。方法 对21例25指Ⅱ区指屈肌腱伴腱周组织严重损伤者，取自体腕伸肌腱腱鞘作游离移植，修复缺损的指屈肌腱背侧或环周腱鞘；并按肌腱损伤时间的早晚，同时作肌腱修复术、肌腱移植术或肌腱粘连松解术。术后共随访到24指，平均随访10个月。 结果 根据Strickland评价标准，优7指，良11指，中5指，差1指；优良率为75 %。 结论 用游离自体腱鞘移植重建指屈肌腱背侧腱鞘或环周腱鞘，可提高肌腱修复术在治疗肌腱伴腱周组织严重损伤中的疗效。

Applicationof tendon sheath graft for tendon repair

    with severe peritendinous injuries

TANG Jinbo, XIE Renguo, SHI De. Department of Hand Surgery, Affiliated Hospital of Nantong MedicalCollege, Jiangsu, Nantong 226001

【Abstract】 Objective To studymethods and results of tendon sheath graft for dorsal digital sheath or circumferentialsheath reconstruction in flexor tendon repair with severe peritendinous injuries. Methods 25 fingers with zone Ⅱ flexortendon and peritendinous structure injury were involved in this study. The sheath defectswere reconstructed with autogenous sheath taken from the first dorsal compartment of thewrist. The tendons were repaired or replaced by a tendon graft or only underwent tenolysisaccording to intervals from the injuries to the repair. 24 fingers were followed for anaverage 10 months and evaluated by Strickland criteria. Results The functional return was excellent in 7 fingers, good in 11, fairin 5 and poor in 1. The good and excellent rate was 75 %. Conclusions Reconstruction of dorsal or circumferential sheath defects usingautogenous sheath graft provides an effective way to improve results of tendon repair withsevere peritendinous injuries.

     ......