V型指深屈肌腱撕脱性损伤附二例报告

Type V avulsion injury of the insertion of the flexor digitorum profundus tendon:2 cases report

指深屈肌腱撕脱性损伤俗称＂运动衣，Jersey＂损伤，常伴有肌腱止点处的撕脱骨折，是一种少见的损伤。国外报道较多，国内也偶见报道[1-2]。Leddy 等[3]早在1977年就根据损伤后肌腱所在的位置，将此种损伤分为3种类型，I 型：撕脱的肌腱回缩到手掌部，肌腱长短腱纽均断裂。II 型：肌腱回缩到近端指间关节，短腱纽断裂，长腱纽完整，肌腱断端常带有小片撕脱骨折。III 型：指屈肌腱止点处撕脱骨折，骨折片较大，常累及关节面，短腱纽完整，骨折片移位到远端指间关节。1981年，Smith [4]对此分型做了新的补充，也就是IV型，即：肌腱止点处撕脱骨折，同时肌腱又从骨折片上撕脱，并向近端回缩。2001年，Al-Qattan [5]报道了4例不同于前几型的损伤，即：屈指深肌腱止点撕脱骨折同时合并末节基底的骨折，他称之为V型损伤，并根据撕脱骨折是否涉及关节面，分为Va和Vb不同类型。2002年，潘勇卫等[1]报道的14例屈指深肌腱撕脱性损伤中有4例是此种类型的损伤。2012年10月29日，我们收治2例非运动性损伤的 V 型屈指深肌腱撕脱伤患者的诊断和治疗进行探讨。

Objective To report uncommon and non-sports type V avulsion injury of the insertion of the lfexor digitorum profundus tendon and to investigate the treatment methods. Methods The clinical results of 2 patients who were both treated in our department on October 29, 2012 were retrospectively analyzed. Results A male patient was 38 years old, whose left ring finger injuries were caused by heavy things. A female patient was 31 years old, whose left little ifnger injures were caused by collision. They were both treated with Kirschner wire ifxation combined with snap pullout of the absorbable polydioxanone suture （ PDS ） II. The 2 patients were followed up for 14 months. The active range of motion of the distal interphalangeal （ DIP ） joint recovered to 90%of that of the normal side. Conclusions Type V avulsion injury of the insertion of the lfexor digitorum profundus tendon is uncommon, and the early diagnosis and surgical treatment is a good choice, with good clinical results.