应用阔筋膜移植修复肌腱缺损的临床研究

Clinical application of fascia lata graft to repair tendon defect

目的探讨应用阔筋膜移植修复肌腱缺损的临床疗效。方法18例肌腱缺损按津下套圈法缝合应用阔筋膜移植治疗进行修复，术后早期应用橡皮筋牵引康复法进行关节功能锻炼。关节功能参照中华医学会手外科学会手部肌腱修复后评定标准评（即总主动活动度测定法）评定。结果所有患者术后早期应用橡皮筋牵引康复法进行关节功能锻炼，关节活动范围基本正常，术后中期有部分患者关节活动范围逐渐减小；术后后期即术后6周以后，关节运动范围基本定型。18例均获随访，时间8～18个月，平均12个月，有3例肌腱黏连严重术后3个月行了松解术。术后关节功能评定：优12例，良5例，差1例，总优良率94．4％。结论应用阔筋膜移植修复肌腱缺损，可以解决移植肌腱来源问题，同时用爱惜邦2-0不吸收编织线按津下套圈法缝合术后可以早期功能锻炼，临床效果良好，值得基层医院推广应用。

Objective To discuss the application and clinical curative effect of fascia lata graft in repair of tendon defect. Methods The eighteen cases of tendon defects were repaired by fascia lata graft, and joint func- tional exercise was conducted by using the rubber band traction method for early postoperative rehabilitation. The joint function was evaluated by referring the scoring system formulated by Chinese Medical Association Society of Hand Surgery. Results All patients received rubber band traction rehabilitation exercise for early postoperative joint function. Their joint range of motion was basically normal and decreased in some patients during the middle postoperative period. Meanwhile,the range of joint motion was fixed 6 weeks after operation. All the 18 patients were followed up for 8 to 18 months, averaging 12 months. Three patients with severe adhesion of tendon received adhesion lysis operation. The postoperative joint function criteria showed excellent in 12 eases, good in 5 cases,and poor in 1 case, with an excellent and good rate of 94.4%. Conclusion Fascia lata graft provides graft sources for repairing tendon defect, and using Ethibond 2-0 sutures can ensure early functional exercise and good clinical effect. This method is worthy of popularization and application in basic-level hospital.