指深屈肌腱撕脱性损伤附14例报告

Avulsion injury of flexor digitorum profundus tendon: report of 14 cases

目的 报道少见的指深屈肌腱撕脱性损伤并补充新的损伤类型。方法 对 1990年 1月至2 0 0 1年 6月收集的 14例患者的病史进行回顾性分析。其中Ⅰ型损伤 5例 ,Ⅲ型 5例 ,不完全符合Leddy和Smith 4类分型的 4例。 2例拒绝手术 ,余 12例均采用手术治疗。结果 12例中 ,术后随访半年～ 10年者 9例 ,远侧指间关节主动活动范围平均为 60° ,其中 4例有平均 12°的伸直缺欠。结论 指深屈肌腱撕脱性损伤早期诊断及手术的疗效较好。 4例不完全符合Leddy和Smith 4型分类者 ,其指深屈肌腱止点处撕脱骨折伴末节指骨基底横行或螺旋状骨折 。

Objective To report uncommon avulsions injury of flexor digitorum profundus tendon and supplement a new type of injury. Methods Between January 1990 and June 2001, 14 patients were treated in our department. Retrospective analysis was done. Five cases fulfilled criteria for injury pattern of type Ⅰ, and 5 for type Ⅲ. Four cases could not be classified by the four type injuries of Leddy and Smith. All patients accepted surgical treatment except 2 cases. Results 9 of 12 were followed up 6 months to 10 years postoperatively. The active range of motion of the DIP joints averaged 60°, with a extension defect of 12° in 4 cases. Conclusions All flexor digitorum profundus tendon avulsions should be diagnosed and surgically repaired as soon as possible. There were 4 cases which had avulsion fractures from the palmar aspect of the distal phalanx with simultaneous spiral or transverse fractures at the base of distal phalanx, and did not fulfill the four type injuries of Leddy and Smith, we suggested they be classified as a type Ⅴ injury.