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.%背景:手指指伸肌腱中央腱损伤常用的治疗方法有Matev法、carrol 法、fowler法及残余中央腱条翻转修复等,但仍存在外观臃肿、肌腱粘连、关节功能受限严重等不良后果.目的:观察中节指背纵列钻孔、节段腱移植修复陈旧性中央腱损伤的临床效果.方法:收集陈旧性中央腱损伤患者80例,按照随机数字表法将患者腱移植治疗组和对照组,每组40例,腱移植治疗组给予中节指背纵列钻孔、游离掌长肌腱条自远位骨孔进入,近位骨孔穿出,缝合牢固固定行节段腱移植治疗;对照组根据病情决定,手术方法包括carrol 法、Matev法、Fowler法,观察两组修复效果.结果与结论:腱移植治疗组优良率为85%,对照组为65%(P < 0.05);VCWS测试腱移植治疗组对原工作适应例数为30例(75%),对照组16例(40%)(P < 0.05).两组患者近指间关节屈曲度入院时、住院15 d、出院前1 d、随访4个月逐渐增大,近指间关节背伸受限度逐渐降低(P < 0.05);治疗后住院15 d、出院前1 d、随访4个月时近指间关节屈曲度与近指间关节背伸度在两组间差异有显著性意义(P < 0.05).结果表明,中节指背纵列钻孔及节段腱移植修复陈旧性中央腱损伤,恢复关节屈曲和背伸功能较好.
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