IIc区早期修复深浅指屈肌腱后A2滑车处理的实验研究

Management of A2 Pulley after the Repair of Double Tendons in Zone IIc

目的 探讨指屈肌腱IIc区单纯切割伤双腱修复后A2滑车不同处理对肌腱功能的影响。 方法 将 2 1只来亨鸡随机分为三组 ,以鸡双足中趾为手术趾 ,在每趾肌腱均造成屈趾浅肌腱 (FDS)、屈趾深肌腱 (FDP)单纯切割伤 ,并行双腱修复 ,A组 :A2滑车完整 ;B组 :A2滑车切开 ;C组 :A2滑车扩大。术后 10周末处死动物 ,对鸡趾分别进行生物力学和形态学评定。 结果 IIc亚区屈肌腱单纯切割伤早期双腱修复后 ,A2滑车切开组与A2滑车扩大组的肌腱滑动距离明显大于A2滑车完整组 ,屈曲功则明显小于A2滑车完整组 ,而A2滑车切开组与A2滑车扩大组之间无论是肌腱滑动距离还是屈曲功在统计学上则无明显差异 ( P >0 0 5 )。 结论 临床上IIc亚区FDS、FDP腱损伤早期双腱修复后作A2滑车切开或扩大成形术 ,有利于肌腱滑动和功能恢复。

Objective [WT5”BZ]To evaluate A2 pulley management after the repair of both flexor digitorum superficialis (FDS) and profundus (FDP) tendons in clean-cut injuries in zone IIc of the hand.[WT5”HZ] Methods [WT5”BZ]Twenty-one leghorn chickens were divided into 3 groups:Group A (A2 pulley intact),Group B (A2 pulley incision) and Group C (A2 pulley enlargement).Both FDS and FDP tendons in zone IIc of long toes were repaired with modified kessler suture after tendon transection.Biomechanical studies of gliding excursion and work of flexion were carried out at the 10th week after the tendon repair.The extent of adhesion was examined. [WT5”HZ]Results [WT5”BZ]There were no significant differences in tendon excursion and work of flexion of the toes between group B and C (P> 0.05).Excursions of FDP tendons in group A were statistically less than those in group B and group C (both,P< 0.001).Work of flexion of FDP tendons were statistically larger in group A than in group B and C (P< 0.05).[WT5”HZ] Conclusion [WT5”BZ]The incision and enlargement of A2 pulley improve functions of the digits after the repair of FDS and FDP tendons in zone IIc of the hand.