刘志刚 张志新 于家傲 130021 长春, 白求恩医科大学第一临床学院手外科 中华手外科杂志 1999 0 15 4


    关键词：腱损伤；筋膜；显微外科手术；解剖学；局部 期刊 zhswkzz 0 肌腱外科 fur -->


    

【摘要】 目的 探讨指伸肌腱滑脱的损伤机制、手术方法和术后复发的关系。方法 1987年至1999年,在17例指伸肌腱滑脱手术中,在修复矢状束、腱帽和关节囊损伤的同时,重视了腱间筋膜的修复。通过模拟实验，分析腱间筋膜、矢状束和腱帽在指伸肌腱滑脱中的作用。结果 术后随访3个月 ～ 10年，17例伸指功能均恢复正常，未见复发者。实验结果证实,切断指伸肌腱桡侧矢状束和腱帽,仅引起指伸肌腱的部分滑脱,此时切断腱间筋膜则引起其向尺侧的完全滑脱。结论 矢状束和腱帽损伤的同时,伴有腱间筋膜损伤是该症关键的病理机制。手术修复腱间筋膜是防止复发的根本。

Etiology ofextensor tendon dislocation and the key points of surgical treatment

LIU Zhigang, ZHANG Zhixin, YU Jiaao. Department of Hand Surgery, The First Clinical Hospital of NormanBethume University of Medical Sciences, Changchun 130021

【Abstract】 Objective To explorethe anatomical characteristics and injury mechanisms of extensor tendon dislocation, andthe relationship between operative methods and postoperative recurrence. Methods 17 cases of extensor tendon dislocation treated from 1987 to 1999were involved. In the operation, in addition to the sagittal band, the extensor tendonhood and the joint capsule, the intertendinous fascia was also repaired. Simulatingexperiments were carried out to analyze the role of the intertendinous fascia, thesagittal band and the extensor tendon hood in the extensor tendon dislocation. Results Normal function of finger extension was recovered in all caseswithout recurrence after 3 months to 10 years follow-up. The results of the experimentshowed that resection of the sagittal band and the extensor tendon hood only resulted inpartial dislocation of the extensor tendon, while additional resection of theintertendinous fascia led to total dislocation of the tendon. Conclusions The mechanism of extensor tendon dislocation lies in the injury ofthe intertendinous fascia combined with the injury of the sagittal band and extensortendon hood. To avoid recurrence, the intertendinous fascia should be repaired.

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