目的 探讨超高频超声检查对手指肌腱断裂诊断及预后评估的临床价值.方法 对37例因外伤怀疑肌腱断裂的患者进行超声检查,术前进行肌腱断端的定位,并随访手术结果.术后定期复查肌腱修复情况,指导患者适时进行康复训练.结果 (1)37例患者中有28例超声检查诊断为完全性肌腱断裂,其中24例行手术治疗,术中所见与超声诊断结果相符;(2)术后超声定期复查,19例为腱性连接,5例为瘢痕连接.5例瘢痕连接中有2例瘢痕形成明显,并与周围组织明显粘连,进行了二次手术,余3例进行系统的康复训练后手部功能基本恢复;(3)9例超声诊断为部分性肌腱断裂患者结合磁共振检查后,行外固定非手术治疗后,手部功能基本恢复.结论 超声检查在手指肌腱断裂诊断中有重要价值,还可以动态观察肌腱愈合情况,鉴别腱性连接还是瘢痕连接,指导患者进行适时、适量的康复训练.%Objective To study the value of ultrahigh frequency ultrasound in finger tendon tears diagnosis and prognosis.Methods Thirty-seven cases of trauma patients with suspected tendon tears were examined by high frequency ultrasound.Before surgery tendon stumps were located,and after surgery the results were followed up.The situation of tendon repair was reviewed regularly.And the results provided guidance for patients' timely rehabilitation.Results Twenty-eight cases were diagnosed of complete tendon tears by ultrasound.And twenty-four cases underwent surgery.The intraoperative findings were consistent with ultrasound diagnosis.After surgery 24 cases were followed up by ultrasound regularly,including 19 cases of tendon connection,and 5 cases of scar connection.Two cases in 5 had obvious scarring,with obvious surrounding tissue adhesion,so a secondary surgery was performed.The other 3 cases recovered after rehabilitation.Nine cases of partial tendon rupture diagnosed by ultrasound combining MRI had external fixation non-surgical treatment.The hand function was restored.Conclusions High frequency ultrasound has important diagnostic value in finger tendon rupture.It can also be helpful in dynamic observation of tendon healing and guiding patients' timely,moderate rehabilitation.
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