儿童Ⅱ区指屈肌腱损伤21例分析

Treatment of flexor tendon injuries in zone in children:a report of 21 cases

目的探讨儿童Ⅱ区指屈肌腱损伤的治疗方法和疗效。方法１９９０年至１９９７年间共收治２１例２３指儿童Ⅱ区指屈肌腱损伤，分析其病史后进行总结。其中男１９例，女２例，年龄５～１４岁，平均１２．１岁。早期１０例１０指，用０号丝线作Ｋｅｓｓｌｅｒ或双十字法缝合。后期１１例１３指在手术显微镜下，用５－０无创尼龙线缝合肌腱及修复腱鞘，均用Ｋｅｓｓｌｅｒ法缝合。非急性期修复者在腱周放置透明质酸钠。结果按ＴＡＭ法评定疗效，早期１０例１０指中，优２指，良６指，可２指，优良率为８０％。后期１１例１３指中，优８指，良５指，优良率为１００％。两组总优良率达９１．３％。结论儿童Ⅱ区指屈肌腱损伤修复后疗效较佳；应用透明质酸钠有助于功能的恢复。

Objective To investigate the treatment of flexor tendon injuries in zone in children,and evaluate its outcome. Methods Flexor tendon injuries in zone in 23 fingers of 21 children,which were treated from 1990 to 1997,were retrospectively analyzed. The age of the patients ranged from 5 to 14 years old, being 12.1 years on average. For the early 10 cases (10 fingers), the tendons were repaired using Kessler's technique or double cross suture with 1 0 silk thread. For the later 11 cases (13 fingers), the tendons were sutured by Kessler's technique with 5 0 nylon, with simultaneous repair of the tendon sheath. Sodium hyaluronate product (SHP) was administered to the peritendon area in cases of none acute repair. Results According to TAM standard, of the early 10 fingers, the result was excellent in 6, good in 2, and fair in 2, with an excellent or good rate of 80 %. Of the later 13 fingers, the outcome was excellent in 8, and good in 5, with an excellent or good rate of 100 %. The overall excellent or good rate was 91.3 %. Conclusions Satisfactory result could be achieved after repair of flexor tendon injuries in zone in children. SHP benefited the functional recovery of the involved fingers.