目的：探讨手指伸肌腱Ⅰ区损伤的最佳手术方法选择。方法本组30例指伸肌腱Ⅰ区损伤患者，其中12例腱部断裂、远端残留＞3.0 mm者，采用5/0无创伤尼龙缝线行肌腱远端“U”字缝合；8例伴撕脱性骨块较大者，采用1.0 mm克氏针固定骨块。对4例骨块较小和6例远端肌腱＜3.0 mm者，采用5/0无创伤尼龙缝线在肌腱近端Kessler法，再横行穿过末节指骨基底部的骨孔，行腱骨固定。30例术后均采用远侧指间关节克氏针过伸位、近侧指间关节屈曲位固定6周。结果术后随访2个月~3年，平均18个月，30例患指功能良好，远侧指间关节活动度0°~55°，肌腱未出现再次断裂。结论依肌腱损伤类型选择相应的修复方式可提高手术疗效。%Objective To clinical investigate the best operation method on the digital extensor damage onⅠArea of treat the finger extends the tendon damage. Methods 30 cases withⅠ area damage, 12 cases of tendon rupture, distal residual > 3.0 mm, 5/0 prolene line tendons distal suture "U" word. 8 cases with excoriation of bone block with strong, with 1.0 mm gram needle fixation of bone. 4 cases of small bone block and 6 cases of distal tendon < 3.0 mm, the 5/0 prolene line suture without trauma in tendon proximal Kessler method, run through the details again basal parts phalanx bone hole, line tendon bone fixation. After operation the DIP were fixed extensor position with kirschner needle and the PIP were fixed flexion position for 6 weeks. Results Postoperative follow-up of 2 months to 3 years, an average of 18 months and 30 cases obtained good function, the dip joint activity mean 0 ° ~ 55 ° , tendons does not appear broken again. Conclusion According to tendon damage type choose corresponding repair method can improve the surgical curative effect.
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