六股和四股技术在修复手部 II 区受伤的深屈肌腱方面的比较:随机对照临床试验。

IF 0.9 Q3 SURGERY World Journal of Plastic Surgery Pub Date : 2023-01-01 DOI:10.52547/wjps.12.2.34
Mohammad Bagher Heydari, Yusef Porhesam, Arian Karimi Rouzbahani, Golnaz Mahmoudvand, Hormoz Mahmoudvand
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引用次数: 0

摘要

背景:手部 II 区屈肌腱修复术与许多并发症有关,因此以前被称为 "无人区"。尽管人们对该区域屈肌腱的主要修复方法已达成一定共识,但由于某些并发症的存在,该区域的修复仍具有挑战性。我们比较了修复 II 区屈指肌腱的六股和四股技术:这项随机对照临床试验已在伊朗临床试验注册中心注册(IRCT20130812014333N139)。纳入 2020 年转诊至伊朗克尔曼沙阿 Taleghani 医院的 50 名手部 II 区肌腱受损患者,并将其分为两组(n=25)。第一组使用四线技术和 prolene 缝合线修复受损肌腱,第二组使用六线技术。术后前三周,每周对患者进行检查。第二周和第三周,拆除缝线。第三个月结束时,比较各组的手术效果:共调查了 50 名患者(74% 为男性)的 85 根受损手指。根据 Buck-Gramcko 标准,78% 的患者手术效果极佳,16% 的患者手术效果良好,4% 的患者手术效果一般,2% 的患者手术效果不佳。术后并发症为粘连(8%)和 2 例断裂。在肌腱粘连和活动范围方面,4股缝合线和6股缝合线没有明显差异:结论:对于手部II区FDP受损的患者来说,4股缝合线和6股缝合线都能带来良好的疗效。
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Comparison of Six-strand and Four-strand Techniques on the Repair of Injured Deep Flexor Tendons of Zone II of the Hand: A Randomized Controlled Clinical Trial.

Background: Hand zone II flexor tendon repair had been associated with many complications thereby it was previously called no man's land. Although there is some agreement on the primary repair of flexor tendons in this area, it is challenging due to certain complications. We compared the six and four-strand techniques in the repair of flexor digitorum profundus (FDP) tendons of zone II.

Methods: This randomized controlled clinical trial was registered with the Iranian Registry of Clinical Trials (IRCT20130812014333N139). Fifty patients with damaged FDP in zone II of the hand who were referred to Taleghani Hospital, Kermanshah, Iran in 2020 were included and divided into two groups (n=25). In group 1, the damaged tendons were repaired using the four-strand technique and prolene suture while in group 2, the six-strand technique was used. Postoperatively, the patients were examined every week for the first three weeks. In the second and third weeks, sutures were removed. At the end of 3rd month, the outcomes of surgery were compared in the groups.

Results: Fifty patients (74% male) with 85 damaged fingers were investigated. Based on Buck-Gramcko criteria, the outcomes of surgery were excellent in 78%, good in 16%, fair in 4%, and bad in 2%. Complications after surgery were adhesion (8%) and 2 cases of rupture. There was no significant difference between 4 and 6-strand sutures regarding tendon adhesion and range of motion.

Conclusion: Both 4 and 6-strand sutures were associated with favorable outcomes in patients with damaged FDP in zone II of the hand.

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