|
Abstract Objective To investigate the therapeutic effect of allogeneic tendon transplantation for repairing tendon defect of hand and functional reconstruction.Methods From March 2015 to June 2017，tendon defect of hand of 18 patients (22 fingers) was repaired by allogeneic tendon transplantation.There were 12 males and 6 females with an average age of (32.9±8.3) ranging from 20 to 45 years old.There were extensor tendon defect of 6 patients (8 fingers)，flexor tendon defect of 12 patients (14 fingers).The length of extensor tendon defect was 6 to 10 cm，the average length was (7.8±2.1) cm.The length of flexor tendon defect was 5 to 8 cm，the average length was (6.6±1.3) cm.The time from injury to operation was 1.5 to 8 months，the average time was (5.0±2.8) months.Skin and soft tissue defect should be repaired by flap transfer before operation，open reduction or bone graft and internal fixation should be performed for fracture and bone defect.The interphalangeal joint or metacarpophalangeal joint of the hand should be actively exercised until the passive activity was normal.Patients of contracture of joint underwent arthrolysis.Extensor tendon was sewed up by the method of weave stitching，and flexor tendon was sewed up by the method of Tsuge or weave stitching，the trochlea of flexor tendon should be repaired or reconstructed.The postoperative antibiotics should be used to prevent infection.The wound should be given regular dressing change，and all patients accepted no the therapy of immunodepressant.From 3 days to 4 weeks after operation patients with extensor tendon transplantation underwent the active finger flexion exercise and passive finger straightening exercise，patients with flexor tendon transplantation underwent the active finger straightening exercise and passive finger flexion exercise，exercise three times a day.After 4 weeks frequency and intensity of the exercise of active flexion and extension should be increased gradually.Total Active Movement evaluation criteria which established by international hand surgery union was used for evaluating the therapeutic effect.Results Fat liquefaction occurred in 3 patients after operation，and the bacterial culture confirmed aseptic exudation，patients of fat liquefaction were given wound dressing and reached to wound healing within 20 days，the rest were healed by first intention.3 patients (5 fingers) were accepted the operation of tendon release due to flexor tendon adhesion.The follow up time was 8~24 months，the average time was (14.7±4.8) months.According to the evaluation result，nine fingers were the best grade，seven fingers were the secondary grade，three fingers were the acceptable grade，three fingers were the lowest grade，the fineness rate was 72.7%.Conclusion Allogeneic tendon transplantation can take the place of autoallergic tendon transplantation for repairing tendon defect of hand，which also can get the hand function recovery.Postoperative tendon adhesion could lead to reduction of fineness rate，aseptic exudation of wound could lead to prolonged wound healing time，the above problems needed to be solved in the future clinical work.
|
|
|
|
|
|
���������� 14010702070875��