指伸肌腱止点形态特点与损伤分型及治疗方法_胡洪涌.pdfVIP

DOI:10.13418/j.issn.1001-165x.2011.04.023 ·458 · CHINESE JOURNAL OF CLINICAL ANATOMY VOL. 29 NO.4 2011 ·临床研究· 指伸肌腱止点形态特点与损伤分型及治疗方法 胡洪涌，赵小伟，窦庆寅，刘国龙 深圳市松岗人民医院骨科，广东 深圳 518105 【摘要】 目的 根据指伸肌腱止点的形态特点探讨其损伤分型与手术修复方法。 方法 依据将28 例指伸肌腱止点区损伤情况分为带较大骨折块手指伸肌腱止点损伤、撕脱骨片小或骨折块粉碎无法固定 及不带骨片的伸肌腱止点撕脱伤、靠近末节指骨基底背侧指伸肌腱腱性损伤3 种类型。按损伤分型分别 采骨块固定，末节指骨基底钻孔缝合固定及直接缝合修补等手术方法进行修复。 结果 28 例无一例再 度撕脱或断裂，其中3 例远侧指间关节僵硬，其余25 例远侧指间关节主动伸直受限度0°~10° ，主动屈曲 度30°~70°。 结论 根据伸肌腱止点损伤的分型，分别采用骨折块固定，末节指骨基底钻孔缝合固定及 直接修补缝合手术方法进行修复，方法简便，疗效可靠。 【关键词】指伸肌腱止点； 损伤；手术修复 【中图分类号】R658.2 【文献标识码】A 【文章编号】1001-165X(2011)04-458-03 Classified surgical treatment in the insertion injury of digital extensor tendon HU Hong-yong, ZHAO Xiao-wei, DOU Qing-yin, LIU Guo-long Department of Hand Surgery, Shenzhen Songgang Peoples Hospital, Shenzhen 518105, China 【Abstract 】 Obj ective To examine the methods of surgical repairs and clinical efficacy in the treatment of the extensor tendon insertion injury. Methods Twenty eight patients with finger extensor tendon insertion injury was categorized into 3 groups: fractures with large blocks, avulsion fracture of bone slices or small bone pieces without bone-crushing which can not be fixed, and tendinous injury at the insertion near the distal dorsal phalanx. The treatments were bone-fix, drilling-fix at the basement of distal phalanx, and direct suture, respectively. Results No re-avulsion or re-fraction occurred in these 28 patients. Stiffness of distal interphalangeal joint was observed in 3 patients. The remaining 25 patients had a limitation of initiative extension for the distal interphalangeal point 0°~10°, and initiative inflextion 30°~70°. Conclusions Targeted selections of bone-fix, drilling-