摘要
目的 探讨高频超声诊断在手指伸肌腱闭合损伤中的诊断价值.方法 2005年4月至2008年10月,应用高频超声诊断指伸肌腱闭合损伤,对手术证实的21例患者的超声影像特征进行分析.结果 Ⅰ区伸肌腱损伤10例中,超声图像显示肌腱止点处低回声区,远节指骨基底向掌侧移位,动态观察主动伸指远节指骨无活动,其中3例合并末节指骨撕脱骨折,骨块均有移位.Ⅱ区损伤6例中,腱帽损伤完全断裂2例,表现为腱帽连续性中断,结构紊乱,局部有异常暗区,动态观察可见断端分离,伸腱滑向尺侧;腱帽损伤未断裂3例,表现为腱帽增厚,回声不均匀,结构不清;内固定损伤1例,可见内固定物在受损肌腱内穿过,肌腱滑动时受阻.Ⅲ区自发肌腱断裂5例,超声图像见肌腱内部回声不均匀,肌腱纤维混乱,肌腱连续性中断.结论 超声检查指伸肌腱闭合损伤是辅助诊断中的首选方法,为临床治疗提供依据.
Objective To explore the clinical value of high resolution ultrasound in the diagnose of digitorm extensor tendon close injury. Methods From April 2005 to October 2008, close injury of the extensor digitorum tendons was diagnosed using high resolution ultrasound in our hospital. The characteristics of ultrasound images of 21 patients whose diagnosis was confirmed by surgery were retrospectively analyzed. Results The extensor digitorum tendons of 10 patients were injured in Zone Ⅰ. Ultrasonic images showed that the low echogenic area was located in the site of extensor tendon insertion into the distal phalanx and the base of the distal phalanx was volarly displaced. The kinesis observation showed that no movement occurred when the patient actively moved the distal interphalangeal joint. There was distal p halanx avulsion fracture and displacement in 3 patients. Zone Ⅱ injury of extensor digitorum tendons was seen in 6 patients. The tendon hood was completely ruptured in 2 cases shown as interruption of continuity of the tendon hood on ultrasonograph. The structure of the tendon hood was disoriented and there was abnormal dark area. The kinesis observation showed that the two ends of tendon hood were separated upon and the tendon slided to the ulnar side of the finger. Tendon hood was injured but not ruptured in 3 cases. Ultrasonographs showed thickening of the tendon, uneven echo signals, and disoriented structures. Iatrogenic tendon hood injury by internal fixation was seen in 1 case. The internal fixation plate could be seen through the tendon and limited tendon excursion. Spontaneous tendon rupture in zone Ⅲ occurred in 5 cases. Ultrasonic images showed uneven echo signals, disoriented tendon fibers, and disrupted tendon integrity. Conclusion High resolution ultrasonic inspection can provide reliable information for the diagnosis of extensor digitorum tendon close injury and valuable clinical information for the choice of operation.
出处
《中华手外科杂志》
CSCD
北大核心
2010年第5期267-269,共3页
Chinese Journal of Hand Surgery
关键词
超声检查
腱损伤
诊断
Ultrasonography
Tendon injuries
Diagnosis
