hand flexor tendon injury
Introduction
Brief introduction of hand flexor tendon injury The flexor tendon of the finger plays a major role in the function of holding the hand. Its anatomical structure is special and adapts to its physiological function. Therefore, the repair of the flexor tendon has its particularity. The flexor tendon has deep, shallow two groups, starting from the forearm, passing through the carpal tunnel, palm, flexor and tendon sheath and respectively resisting the proximal phalanx and the proximal phalanx. There is loose connective tissue around the entire tendon, which not only nourishes the tendon, but also slides the tendon in it. It is called Paratenon. basic knowledge Sickness ratio: 0.0012% Susceptible people: no special people Mode of infection: non-infectious Complications: metacarpophalangeal joint dislocation
Cause
Causes of flexor tendon injury in the hand
(1) Causes of the disease
Mostly caused by cutting injuries and stab wounds.
(two) pathogenesis
After the tendon trauma is broken, due to the contraction of the muscle, the proximal end of the retraction can be retracted even far, such as cutting at the proximal phalanx, the broken end can be retracted back to the palm, when the tendon is injured, the finger is often present The buckling grasping shape, after the joint is straightened, the distal end of the joint is moved forward. It is difficult to find both ends during the operation, and the repair is difficult. After the suture, there is a tension, and the suture can be separated and cracked, which affects the healing.
There is no bleeding blood vessel in the tendon. After cutting, can it heal itself like other tissues. There has been controversy. Exogenous healing theory has dominated for a long period of time. It believes that tendon lacks its own healing ability and must be transported by the surrounding blood. The rich tissue grows into the granulation and repairs it, especially in the area of the sheath tube. The sheath affects the granulation growth, and the part must be removed to make the tendon heal. The scar formation causes the tendon to stick, and the effect of the tendon sliding function is inevitable after the tendon repair. As a result, in the sheath portion, especially in the II region, the initial treatment is limited to repairing the surrounding soft tissue, and the late tendon is transplanted to reconstruct the flexion function. For initial repair, it is limited to neat non-contaminated cutting injury, and the partial tendon sheath is cut off. Resection of the proximal finger refers to the superficial flexor tendon and sutures the deep flexor tendon to reduce adhesions, preserves the activity function, refers to the deep, and the shallow flexor tendon is repaired, then the adhesion to each other makes the function more important, and the result is counterproductive.
Prevention
Hand flexor tendon injury prevention
Avoid trauma.
Complication
Hand flexor tendon injury complications Complications of the metacarpophalangeal joint
Improper treatment or treatment, the hand holding function is a serious obstacle.
Symptom
Hand flexor tendon injury symptoms Common symptoms Finger (toe) swelling finger joint pain swelling fingers can not bend and flexion wrist flexion weakness
Tendon is a transmission device for joint activity, which is an important part of the normal function of the hand. Even if the functions of the joints of the hand are normal, the function of the hand will be completely lost after the tendon is damaged.
Part of the flexor tendon: due to the specificity of the anatomical structure of the flexor tendon in different parts, the treatment principles and methods are not the same, according to Verdan classification, can be divided into 5 areas.
Zone I: The middle finger of the finger refers to the point between the shallow flexor stop and the distal end of the deep flexor. The thumb is the middle of the proximal segment to the flexor hallucis of the thumb.
Zone II: Middle section of the phalanx to the neck of the metacarpal, often referred to as the "no man's land."
Zone III: "Hand palm", the distal edge from the neck of the metacarpal to the transverse ligament of the wrist.
Zone IV: carpal tunnel area.
Zone V: Forearm zone.
The flexor tendon of the thumb is also divided into 5 zones:
Zone I: the point of attachment of the flexor hallucis longus.
Zone II: proximal phalanges to the metacarpal neck, ie the tendon sheath area.
Zone III: Large fish muscle area.
Zone IV: carpal tunnel area.
Zone V: Forearm zone.
Examine
Examination of flexor tendon injury in the hand
No relevant laboratory tests.
X-ray examination showed no positive findings.
Diagnosis
Diagnosis and differentiation of hand flexor tendon injury
According to the history of trauma, the injured part, and the flexion disorder of each finger joint, it can be judged whether the fingers are deep or shallow (the thumb is long or short) and which area belongs to the fracture.
