移植腱周膜包绕腱缝合段防止指屈肌腱粘连

Wrapping of flexor tendon anastomotic site with peritenon graft for prevention of adhesion

目的：防止指屈肌腱修复术后的粘连。方法：设计并应用了掌长肌腱腱周膜游离移植包绕腱缝合段的新方法。配合术后早期功能锻炼，治疗Ⅱ区指屈肌腱损伤４０例５８指。结果：术后随访１至８年，功能按ＴＡＭ法评定：５８指中，优２０指，良３２指，可５指，差１指，优良率为８９．６％。结论：腱周膜是腱周固有的、利于肌腱滑动及营养的组织。包绕腱周膜腱缝合段，不会破坏肌腱的外源性愈合，又使粘连疏松。通过早期功能锻炼。

Objective: To prevent adhesion after tenorrhaphy of flexor tendons.Methods: 40 cases with 58 digits of flexor tendon rupture in zone II were involved in this series.A new procedure was developed in which the peritenon of palmaris longus was harvested to wrap around the flexor tendon suturing site. Early postoperative rehabilitation was practiced.Results: All the patients were followed up for 1 to 8 years. The functional results assessed by TAM method were excellent in 20 digits, good in 32 ones, fair in 5 and poor in one. The excellent and good rate was 89 6%. Conclusions: The multil aminated peritenon interposed between the anastomotic site and the peritendonous tissues would not hinder the extrinsic healing of the tendon. The loose adhesion formed allows good tendon gliding through early functional rehabilitation.