改良缝合技术在Ⅱb区屈肌腱损伤中的应用

The application of modified suture technique in the repair of zone Ⅱ flexor tendon injury

目的探讨改良缝合技术修复Ⅱb区屈肌腱损伤的临床治疗效果。方法自2013年10月至2014年8月，我们对12例Ⅱb区屈肌腱损伤患者采用了改良缝合技术进行修复，缩短浅腱“v”形桡侧束，尺侧束相对弧形延长，为深肌腱在鞘管内滑行提供新的空间，深肌腱不再走原解剖“v”形隧道，改走相对延长后的尺侧浅腱束浅面，重建屈指功能。结果术后12例均获得随访，时间为6～12个月，平均7个月，患指屈伸功能恢复良好。按中华医学会手外科学会上肢部分功能评定试用标准评定：优8例，良3例，可1例。结论手指Ⅱb区采用改良缝合技术修复使深肌腱在延长后的尺侧浅腱束浅面滑行，克服了卡压和粘连的风险，最大限度满足手指屈伸活动功能，治疗效果满意。

Objective To explore the clinical outcomes of Zone l]b flexor tendon repair with a modified suture technique. Methods From October 2013 to August 2014, 12 eases of flexor tendon injury in Zone Ⅱ b were treated with a modified suture technique where the ＂V＂ shape radial band of the flexor digitorum superfieialis （FDS） was shortened and the ulnar band of FDS was lengthened to create a curve that allowed gliding space for flexor digitorum profundus （FDP） tendon. The repaired FDP tendon was rerouted from the original ＂V＂ shaped tunnel to the elongated ulnar FDS band. Results All 12 cases were follow - up for 6 to 12 months （7 months on average） postoperatively. Flexion and extension of the involved fingers were good. Based on the functional evaluation criteria for the upper extremity issued by the Hand Sttrgery Society of the Chinese Medical Association, the results were rated as exeellem in 8 cases, good in 3 cases and fair in 1 case. Conclusion The modified suture technique allows gliding of the repaired FI）P tendon on top of the lengthened FDS ulnar band. It avoids the risk of tendon kinking and adhesion, allows for maximum flexion and extension, and leads to satisfactory results when used to repair Zone ]I b flexor tendon injuries.