摘要
目的总结小儿屈肌腱损伤治疗的经验,探讨合理的手术治疗方法。方法对近5年来收治的11例小儿屈肌腱损伤患儿(其中Ⅰ区屈肌腱损伤2例,Ⅱ区屈肌腱损伤9例)行手术治疗。所有操作均在手术放大镜下完成,缝合方法选择常规的改良Kessler法,同时修复损伤的鞘管;不进行成人患者使用的支具下早期主动伸指、被动屈指功能练习,术后每日被动屈指练习3次,其余时间皆于外固定下;早期(3周)去石膏行自由状态下的功能练习。结果Ⅰ区屈肌腱损伤的2例患儿的TAM值和%TAM值分别为220°、270°和83%、98%。Ⅱ区屈肌腱损伤的9例患儿治疗结果为:TAM值178°～265°(平均230°),%TAM值67%～100%(平均82%),优2例,良5例,中2例。其中评价结果为中的2例患儿分别于术后3个月和4.5个月行肌腱松解术,松解术后2例患儿的TAM值皆大于200°,恢复了满意的效果。所有病例中无一例发生肌腱断裂者。结论小儿屈肌腱损伤早期采用显微外科修复可取得满意的疗效。
Objective To summarize the therapeutic results of acute flexor tendon injuries in children. Methods Eleven children （2 within zone Ⅰ and 9 within zone Ⅱ ） with flexor tendon injuries were treated surgically in these institutes. All the operations were undergone under operating loupe. The flexor tendons were repaired by modified Kessler method and the tendon sheaths were reconstructed simultaneously. The early stage motion exercise was not recommended in this series, while negative exercise of flexion and extension of treated fingers was performed once a day. The plasters were released for the function exercise at 3 weeks after operation. Results Two children with I -zone flexor tendon injuries achieved excellent recovery with 220° and 270° of total active motion （TAM） and 83%, and 98% of %TAM,respectively. Among the 9 children with 11 -zone flexor tendon injuries,2 obtained excellent recovery,5 good, and 2 fair with 178°-265° of TAM （average, 230°） and 67%-100% of TAM （average,82%）. The 2 children with fair function underwent tendon release at 3 months and 4. 5 months after the first operation. The TAM regained more than 220° in these two children. There were no tendon ruptures in this series. Conclusions Acute flexor tendon injuries in children can be treated satisfactorily with microsurgical techniques.
出处
《中华小儿外科杂志》
CSCD
北大核心
2007年第4期187-189,共3页
Chinese Journal of Pediatric Surgery
关键词
腱损伤
手损伤
儿童
Tendon injuries
Hand injuries
Child
