Segmental tendon graft to repair old central tendon injury: a functional evaluation of articular flexion and extension

doi:10.3969/j.issn.2095-4344.2015.20.025

Abstract

Abstract:

BACKGROUND: Common therapies for damage to the central tendon of finger extensor tendon include Matev, Carroll, Fowler methods as well as residual central tendon flipping repair, but the therapeutic effects are no satisfied with bloated appearance, tendon adhesions, limited joint function.
OBJECTIVE: To investigate the clinical effects of dorsal longitudinal drilling and segmental tendon graft to repair old central tendon injury.
METHODS: Eighty patients with old central tendon injury were randomized into treatment group and control group, with 40 cases in each group. In the treatment group, dorsal longitudinal drilling and segmental tendon transplantation were given; while in the control group, Carroll, Matev, Fowler methods were chosen according to the individual conditions. Then, the therapeutic outcomes were compared between two groups.
RESULTS AND CONCLUSION: The excellent and good rate was 85% in the treatment group and 65% in the control group, and there was a significant difference between the two groups (P < 0.05). Results from Valpar Component Work Samples showed that the number of cases adapting to the original work was 30 cases (75%) in the treatment group and 16 (40%) in the control group, and there was also a significant difference between the two groups (P < 0.05). The degree of proximal interphalangeal joint flexion was increased gradually in the two groups at admission, at 15 days after hospitalization, at 1 day before discharge and at 4 months after discharge,
and meanwhile, the degree of proximal interphalangeal joint dorsiflexion was reduced gradually (P < 0.05). There were significant differences in the degree of proximal interphalangeal joint flexion and degree of proximal interphalangeal joint dorsiflexion between the two groups at 15 days after hospitalization, 1 day before discharge, and 4 months after discharge (P < 0.05). These findings indicate that the dorsal longitudinal drilling and segmental tendon graft for repair of old central tendon injury can play an effective role in the recovery of articular flexion and extension function.

Key words: Fingers, Tendon Injuries, Transplantation

CLC Number:

R318

Feng Zi-ping, Zhu Ju-qing, Qiu Xin, Li Jiang, Tu Qing-hong. Segmental tendon graft to repair old central tendon injury: a functional evaluation of articular flexion and extension [J]. Chinese Journal of Tissue Engineering Research, 2015, 19(20): 3248-3252.

Figures/Tables 4

References

[1] 胡建桥,魏鹏,陈薇薇,等.微型钢板侧方内固定治疗手指近中节指骨骨折的疗效分析[J].现代实用医学,2013,25(6):629-632.

[2] 张恒,王群,金华,等.力学平衡原理治疗陈旧性伸指肌腱中央腱断离[J].基层医学论坛, 2011,15(6):491-494.

[3] 胡俊峰.侧腱束并缝术治疗陈旧性中央腱束断裂损伤的疗效分析[J].齐齐哈尔医学院学报,2012,33(5):613-616.

[4] 叶永奇.陈旧性中央键损伤分期手术疗效分析[D].山西医科大学,临床学院,骨科,2009:1-6.

[5] 吴剑,郑勇,刘艳西.闭合急性与陈旧性跟腱损伤手术重建的中远期疗效[J].实用骨科杂志,2014,20(4):376-379.

[6] 王建然,徐衍祥.侧腱束修复陈旧性中央腱损伤的技术改进[J].中华手外科杂志,2010,14(4):123-126.

[7] Maeda E,Noguchi H,Tohyama H,et al.Biomechanical study of healing of patellar tendon after resection of the central one-third in an adult-mature rabbit model.Biomed Mater Eng. 2013;23(3):173-181.

[8] Xerogeanes JW,Hammond KE,Todd DC.Anatomic landmarks utilized for physeal-sparing, anatomic anterior cruciate ligament reconstruction: an MRI-based study.J Bone Joint Surg Am.2012;94(3):268-276.

[9] Nwafor IA,Eze JC,Aminu MB.Traumatic diaphragmatic rupture through the central tendon with herniation of the stomach and coils of small bowel into the pericardial cavity. Niger J Med.2011;20(4):492-493.

[10] Robert HE,Casin C.Valgus and flexion deformity after reconstruction of the anterior cruciate ligament in a skeletally immature patient.Knee Surg Sports respTraumatol Arthrosc. 2010;18(10):1369-1373.

[11] Kong GM,Gwak HC,Kim JG.A Comparative Study of Surgical Treatment in the Ｒuptured Achilles Tendon:Minimal incision and Open repair.Korean Foot Ankle Soc.2012；16(3):181-189.

[12] Kearney RS, Achten J, Lamb SE, et al.The Achilles tendon total rupture score: A study ofonsiveness,internal consistency and convergent validity on patients with acute Achilles tendon ruptures. Health Qual Life Outcomes. 2012;10:24.．

[13] 叶永奇,梁炳生,田江华.中央腱损伤的治疗进展[J].实用手外科杂志,2008,22(4):223-226.

[14] 赵世伟,邱旭东,赵炳显,等.借助伸腱装置动力结构变化的肌腱移植矫正钮扣状畸形[J].中国组织工程研究与临床康复,2007, 11(8): 1410-1412.

[15] Katarina NH,Karin GS,Ｒoland T,et al.Acute Achilles Tendon Ｒupture: A Ｒandomized，Controlled Study Comparing Surgical and Nonsurgical Treatments Using Validated Outcome Measures. Am J Sports Med. 2010;38(11): 2186-2193.

[16] 于亚东,郭清,邵新中,等.手指伸肌腱装置的应用解剖学研究[J].河北医药,2002,24(8):616-618.

[17] 杨新明,邹宇纬,刘肃近.侧指间关节掌侧脱位伴指伸肌腱中央腱束和侧副韧带断裂[J].中华手外科杂志,2002,18(2):72-74.

[18] Khan RJ,Fick D,Keogh A,et al.Treatment of acute achilles tendon ruptures. A meta-analysis of randomized controlled trials.J Bone Joint Surg(Am).2005;87(10):2202-2210.

[19] 杨华,周初松.超声诊断近端指间关节伸指肌中央腱断裂的临床研究[J].第一军医大学学报,2012,25(5):556-558.

[20] 毛宾尧,林圣洲.临床骨科手册[M].2版.北京:人民卫生出版社, 2006,675-677.

[21] 刘增兵,张峥嵘,王丽萍,等.改良经骨隧道掌长肌腱腱片移植治疗锤状指畸形[J].中国骨与关节损伤杂志,2014,29(5):512-514.

[22] 刘娟,郑怀远,翁雨雄,等.Mitek微型骨锚钉治疗陈旧性锤状指的疗效分析[J].中国骨与关节损伤杂志,2013,28(1):92-93.

[23] 寿建国,付彪,徐晓汉,等.修薄股前外侧皮瓣联合阔筋膜修复手和足部复合组织缺损[J].中华显微外科杂志,2013,36(3):273-275.

[24] 李占雨,刘峰,杨光,等.不同方法重建手指屈指深肌腱止点的生物力学研究[J].中国实验诊断学,2014,18(2):309-310.

[25] 孙景东,刘小涛,谢易,等.自体半腱肌双股重建治疗膝关节内侧副韧带陈旧性损伤疗效观察[J].山东医药,2015,55(1):91-93.

[26] 唐辉,徐永清,杨晓勇,等.改良自体掌长肌肌腱移植治疗陈旧性腱性锤状指[J].临床骨科杂志,2014,17(3):350-361.

[27] 黄俊.皮瓣在手指软组织缺损修复中的应用研究进展[J].安徽医学,2014,35(6):857-859.

[28] 卢启贵,王平,黄东红,等.自体半腱肌转移解剖重建膝内侧副韧带Ⅲ度损伤的临床疗效分析[J].中国骨与关节损伤杂志,2014, 29(1): 94-95.

[29] 官小丽,赵霞,曾化英,等.分期综合性护理对手指屈肌腱损伤患者预后的影响[J].河北医药,2015,37(5): 5789-5791.

[30] 陈捷,魏桂菊,刘桔慧.手指屈肌腱损伤患者的分期综合性护理[J].护理实践与研究,2010,7:53-55.