移植部分鹅足囊修复腱鞘预防指屈肌腱粘连

目的 探讨指屈肌腱损伤修复后重建腱鞘预防肌腱粘连的手术方法.方法 对78例屈肌腱损伤患者,按手术方法的不同随机分为2组.治疗组39例指屈肌腱损伤修复后切取自体部分鹅足囊修复腱鞘,重建腱鞘的完整,使之形成一完整的闭合鞘管并注入玻璃酸钠.对照组不修复腱鞘.结果 经6～38个月临床随访,按TAM手指功能评价治疗组：优21例,良11例,中6例,差1例,优良率82.1%;对照组优良率51.3%,差异有显著性（Х^2=8.34,P=0.004）.结论 切取部分鹅足囊移植修复并应用具有营养和润滑作用的玻璃酸钠,能有效预防指屈肌腱修复后的粘连,是实用的手术方法.

Transplantation of part bursa anserine to repair defects of the tendon sheath for preventing the flexor tendon adhesion

Objective To investigate a surgical method to resconstruct the tendon sheath completely for preventing the tendon adhesion after the flexor tendon injured. Methods Seventy-eight patients divided into treatment group and control group according to the different operation methods. In the treatment group, Cut portion of the bursa anserina graft to repair the flexor tendon sheath defect after the tendon repaired,a complete reconstruction of tendon sheath, so that formatting a closing sheath and injection of sodium hyaluronate. In the control group the same operation was done except to repair the flexor tendon sheath defect. Results After 6-38 months of chnical follow-up the effect was excellent, to evaluate the finger functions according to TAM,21 excellent case, good 10 case,while 4 case,poor 1 case. The difference with control group was statistically significant （Х^2=8.34, P=0.004）. Conclusion Cut a portion of the bursa anserina transplantation to repair the tendon sheath defect after repairing the tendon so that there is a stable internal environment and in combination with the role of nutrition and lubrication of sodium hyaluronate can be defective in preventing adhesion after flexor tendon repair,this is a useful surgical method.