异体肌腱移植在临床修复中的应用

CLINICAL APPLICATION OF ALLOGENEIC TENDON

目的探讨深低温冷冻处理的异体肌腱在临床修复中的应用。方法1995年3月～2002年6月,应用深低温冷冻处理的异体肌腱,移植修复96例肌腱断裂、缺损。其中手部屈肌腱缺损32例,伸肌腱缺损19例,肩喙锁韧带断裂36例,膝关节前交叉韧带断裂4例,跟腱断裂2例,足趾伸肌腱缺损3例。损伤至手术时间1d～5个月。肌腱缺损长度4～12cm,平均7cm。术中选择相匹配的异体肌腱,术后早期功能锻炼,肌腱粘连者行二期松解术。结果术后随访6个月～5年,平均3.4年,术后无排斥反应,无移植肌腱再断裂,优良率达92.71%。结论深低温冷冻处理的异体肌腱移植修复,愈合机制、功能与自体肌腱相似,效果满意,可广泛应用于临床。

Objective To explore the clinical application of allogeneic tendon handled by ultra-deep-low-temperature. Methods From March 1995 to June 2002,tendons rupture and tendons defect were repaired by ultra-deep-low-temperature allogeneic tendon grafts in 96 cases, including 51 cases of flexor or extensor tendon defect of hand, 36 cases of coracoclariculare ligament rupture, 4 cases of cruciate ligament rupture, 2 cases of calcaneus tendon rupture and 3 cases of extensor tendon defect of foot. The interval between injury and operation was 1 day to 5 months. The length of defect was 4-12 cm with an average of 7 cm. The matching allogeneic tendons were selected during operation, and early function exercise was done after operation. Secondary release was performed in the cases of tendon adhesion. Results Follow-up time is from 6 months to 5 years （3. 4 years on average）. No rejection or rupture occurred after tendon allograft. The satisfactory result was achieved in 92. 71%0 of the cases. Conclusion The allogeneic tendon is similar to auto-tendon in transplanting, healing and function is useful clinically.