同种异体肌腱修复肌腱缺损的远期疗效观察

目的总结同种异体肌腱修复肌腱缺损的远期临床疗效。方法 1996年10月-1999年9月,采用经脱氧鸟苷培养冷冻保存与超深低温处理的同种异体肌腱移植修复肌腱缺损24例。男19例,女5例;年龄12～46岁,平均25.9岁。2～5指指总伸肌腱缺损7例,示指伸肌腱缺损7例;2～5指指深屈肌腱缺损3例,环指指深屈肌腱缺损1例;2～5趾趾长伸肌腱缺损3例;长伸肌腱缺损2例;肩胛带离断再植术后肩内收不能1例。肌腱缺损范围5～15 cm。受伤至手术时间为2 h～3个月,平均1.3个月。结果术后切口均Ⅰ期愈合,无深部感染及传染性疾病发生。患者均获随访,随访时间10～12年,平均10.8年。与对侧相同或相近关节比较,术后10年随访时1例4条移植肌腱有6～10°屈曲功能丢失,术后10.6年行屈肌腱松解,术中见同种异体肌腱色泽、弹性正常,直径较原肌腱减少约1/3,有轻度到中度粘连,松解术后功能改善明显;余患者关节伸屈功能良好。根据中华手外科学会手功能评价标准评定临床效果,获优12例,良6例,差6例,优良率达75%。结论脱氧鸟苷培养冷冻处理与超深低温处理的同种异体肌腱均可安全用于临床,其修复肌腱缺损的远期效果较好。

LONG-TERM EFFECTIVENESS OF TENDON ALLOGRAFT FOR REPAIRING TENDON DEFECT

Objective To observe the long-term effectiveness of tendon allograft to repair tendon defect.Methods Between October 1996 and September 1999,24 patients with tendon defect were treated with tendon allograft which was cultured with deoxyguanosine and preserved at low-temperature or ultra-deep-low-temperature.There were 19 males and 5 females,aged from 12 to 46 years with an average of 25.9 years.These patients included 7 cases of total extensor tendon defect of 2nd-5th fingers,7 cases of index finger extenso...