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BACKGROUND:Common therapies for damage to the central tendon of finger extensor tendon include Matev, Carrol, Fowler methods as wel as residual central tendon flipping repair, but the therapeutic effects are no satisfied with bloated appearance, tendon adhesions, limited joint function. OBJECTIVE:To investigate the clinical effects of dorsal longitudinal driling and segmental tendon graft to repair old central tendon injury. METHODS:Eighty patients with old central tendon injury were randomized into treatment group and control group, with 40 cases in each group. In the treatment group, dorsal longitudinal driling and segmental tendon transplantation were given; while in the control group, Carrol, Matev, Fowler methods were chosen according to the individual conditions. Then, the therapeutic outcomes were compared between two groups. RESULTS AND CONCLUSION:The excelent and good rate was 85% in the treatment group and 65% in the control group, and there was a significant difference between the two groups (P < 0.05). Results from Valpar Component Work Samples showed that the number of cases adapting to the original work was 30 cases (75%) in the treatment group and 16 (40%) in the control group, and there was also a significant difference between the two groups (P < 0.05). The degree of proximal interphalangeal joint flexion was increased gradualy in the two groups at admission, at 15 days after hospitalization, at 1 day before discharge and at 4 months after discharge, and meanwhile, the degree of proximal interphalangeal joint dorsiflexion was reduced gradualy (P < 0.05). There were significant differences in the degree of proximal interphalangeal joint flexion and degree of proximal interphalangeal joint dorsiflexion between the two groups at 15 days after hospitalization, 1 day before discharge, and 4 months after discharge (P < 0.05). These findings indicate that the dorsal longitudinal driling and segmental tendon graft for repair of old central tendon injury can play an effective role in the recovery of articular flexion and extension function.
RESUMO
Objective To analyze the causes and treatment measures of postoperative ulnar deviation hand deformity etiology.Methods Clinical data of 17 cases of hand injuries postoperative ulnar deviation hand deformities were retrospectively analyzed.Results 17 patients with metacarpallosteotomy miniplate fixation of four cases of angular deformity jointly carpometacarpal joint instability of joint fusion and internal fixation of eigi.t cases,the metacarpal instability for interbody fusion of five cases of Kirschner wire;all patients were discharged,length of stay from 15 to 24d,the average ( 17.6 ± 2.1 )d.Concurrent ulnar deviation a hand deformity of the main reasons:patients with the palm of your hand refers to the joint dorsal aponeurosis and the extensor tendon to the ulnar tension increases,and the inside with the palm of your hand musoles to antagonize;the metacarpal multiple fractures caused by malunion or carpal joint instability;deep palmar transverse ligament metacarpal caused by the relative instability.Concurrent ulnar deviation hand deformity in 2 to 7 months after surgery,the average (4.1 ± 1.1 ) months;index finger,middle finger,ring finger and little finger and thumb before and after treatment,the declination differences were statistically significant( t =9.3213,9.8826,9.3605,9.4561,all P ＜ 0.05 ).Follow-up for 1 to 3 years,ulnar deviation hand deformities have been effectively corrected.Conclusion The palm of your hand after crush injury complicated by ulnar deviation hand deformity have a variety of reasons,need to take surgery.