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目的探讨自体大隐静脉移植重建腱鞘缺损防止儿童指屈肌腱Ⅱ区损伤中术后粘连的临床效果。方法回顾总结儿童指屈肌腱Ⅱ区损伤应用显微外科手术,采用自体大隐静脉移植重建腱鞘缺损38例,修复56根肌腱及鞘管。结果经6～24个月随访,采用TAM系统法评定疗效:优45指,良6指,可5指,总优良率91.07%,术后无发生肌腱粘连。结论自体大隐静脉移植重建腱鞘缺损防治在儿童指屈肌腱Ⅱ区损伤术后肌腱粘连,手术操作简单,取材方便,效果优良,易于临床推广应用。
Objective To investigate the clinical effect of autologous saphenous vein graft reconstruction of tendon sheath defect preventing postoperative adhesion in flexor tendon Ⅱ area of children. Methods The microsurgical operation of the injured area of flexor tendon Ⅱ was retrospectively reviewed. Thirty-eight cases of tendon sheath defects were reconstructed with autologous saphenous vein and 56 tendons and sheaths were repaired. Results The patients were followed up for 6-24 months. TAM system was used to evaluate the curative effect: excellent 45, good 6, and 5 fingers, the total excellent and good rate was 91.07%. No tendon adhesion occurred after operation. Conclusion Reconstruction of tendon sheath defect with autologous saphenous vein transplantation in the prevention and treatment of tendon adhesion in children with flexor tendon Ⅱ area after operation is simple, easy to draw, excellent in effect and easy to be popularized in clinic.