digital flexor tendon deferred suture

It is suitable for the right middle finger proximal volar injury for 3 weeks, the wound has healed, and the injured finger can not actively flex. Tendon ruptures and defects are common diseases, mostly caused by injuries or lesions. In order to restore the function of the limbs, fingers and toes, the broken or defective tendons must be repaired in time. However, almost all repaired tendons form different degrees of adhesion and joint activity disorder with surrounding tissues, which is closely related to local pathological conditions, surgical technique, suture material, and correct postoperative treatment, and must be taken seriously. Treatment of diseases: hand flexor tendon injury hand tendon injury Indication 1. Acute or old tendon injury and fracture or defect. 2. Open injury tendon rupture, within 8 to 12 hours after injury, the pollution is not heavy, debridement thoroughly, with complete healthy skin coverage, suture the tendon in one stage. Otherwise, it should be postponed or the wound should be repaired after the wound is completely healed. 3. Tendons that need to be cut or partially removed due to tumors or other lesions should be repaired in one stage. Contraindications 1. The infection after the local injury has not been eliminated. 2. Injury refers to the passive flexion and extension of each joint. Preoperative preparation 1. Edema and inflammation of the limbs and wards, even if mild, should be actively treated, so that it completely disappears after 2 to 3 months of surgery. 2. Local large and hard scars should be removed first and the flaps should be repaired to ensure a good blood supply and a soft loose tissue bed around the tendons. 3. Before the tendon is sutured, the joint stiffness of the dominant tendon should be treated first, and the physical therapy and active and passive exercise should be given to restore the greater activity, so that the effect of the tendon suture can be operated and received. 4. The suture material should be selected from the varieties with small reaction, large pulling force and smooth surface. Generally, soft stainless steel wire with a diameter of 0.25 to 0.30 mm is preferred, and is mostly used for drawing steel wire stitching. Surgical procedure 1. After the wound is debrided, the ulnar side of the affected finger is made into a "Z"-shaped incision. The tendon sheath is cut at the broken sac, and the distal and proximal ends of the tendon are found. The needle is inserted across the tendon of the tendon for temporary fixation. Suture the tendon. 2, with 3 / 0 non-invasive suture needles, modified Kessler suture method suture the finger shallow, deep flexor tendon. The cut tendon sheath was repaired with a 5/0 needle thread. 3, after the installation of early passive traction traction brace. Can be made of plaster or plastic plate, control the wrist at 60 degrees of palm flexion, metacarpophalangeal joint 20-40 degrees palm flexion, proximal interphalangeal joint 20 degrees palm flexion. Attach the hook to the nail end of the finger or sew through the thick thread, and then attach it to the distal side of the forearm with a rubber band. complication Suppurative infection, infected wounds have pain, redness, tenderness, purulent secretions, etc., body temperature can be increased and neutrophils can be increased. Closed wounds may also be associated with various infections, such as post-injury aspiration, airway endocrine retention, and atelectasis secondary lung infections.