屈肌腱松解移位治疗儿童先天性指屈肌腱短缩△

Flexor tendon release and transposition for congenital flexor tendon shortening in children

摘要:

[目的] 介绍指屈肌腱移位术治疗儿童先天性指屈肌腱短缩的临床技术和初步临床结果。[方法] 对2 例儿童先天性指屈肌腱短缩者行上述治疗。完善术前准备，在患指掌侧腕部正中做纵行小切口，保护血管神经，显露患指的指深屈肌和指浅屈肌腱性部分，判断整体肌腱短缩程度。适当位置分别离断指浅屈肌腱和指深屈肌腱，在休息位，将指浅屈肌腱近端与指深屈肌腱远端移位吻合牢固，利用指浅屈肌为动力肌屈伸患指，实现改善屈曲指外观和功能的目的。[结果] 2 例患者各患指均顺利完成手术，术中无血管、神经损伤。指近端指间关节（proximal interphalangeal, PIP） 屈伸度术前0°~30°，术后1 年随访时为0°~100°，指畸形外观改善显著，肌力无减弱。[结论] 指屈肌腱移位术治疗儿童先天性指屈肌腱短缩操作简单、疗效确切，术后患指功能、外观均显著改善。

Abstract:

[Objective] To introduce the surgical technique and preliminary clinical outcomes of flexor tendon release and transpositionin the treatment of congenital flexor tendon shortening in children. [Methods] Two children with congenital flexor tendon shortening weretreated surgically. After preoperative preparation, a small longitudinal incision was made in the middle of the palm wrist corresponding to theaffected finger to expose the superficial and deep flexor tendons of the involved fingers with protection of the blood vessels and nerves, andjudging the overall extent of tendon shortening. As the superficial and deep tendons were cut in proper level, the proximal end of the superfi-cial flexor tendon was firmly sutured with the distal end of the deep flexor tendon of the finger under proper tension in the rest position. Thesuperficial flexor muscle of the finger was used as the power muscle to flex the affected finger, so as to improve the appearance and functionof the flexor finger. [Results] The operation was successfully completed in each affected finger of the 2 patients, without vascular or nerve in-jury during the operation. The range of motion of the proximal interphalangeal (PIP) joint improved from 0°~30° before operation to 0°~100°1 year postoperatively, with significant improvement in the appearance of the deformity and no decline in muscle strength. [Conclusion]This tendon release and transposition in the treatment of congenital flexor tendon shortening in children is simple and effective, and the func-tion and appearance of the affected finger are significantly improved after operation.