Deep flexor tendon transplantation, zone II (allogeneic tendon transplantation)

Suitable for left ring refers to old injury, refers to shallow, deep flexor tendon defect, zone II. Treatment of diseases: tendonitis, hand tendon injury Indication Suitable for left ring refers to old injury, refers to shallow, deep flexor tendon defect, zone II. 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 During the operation, 1 hour before the transplant is expected, a sterile table is additionally placed, which is separated from the surgical instrument vehicle to avoid pollution. The compound lactated Ringer's solution of 15-20 ° C was prepared in a rewarming container, and under the aseptic conditions, the cryopreserved allogeneic bone was taken out from the package in parallel with the first bacterial culture. The allogeneic bone was placed in the thermostatic compound lactated Ringer's solution for 15 minutes, and then taken out, and the second bacterial culture was performed. After washing for 5 min in an antibiotic solution (40,000 U gentamicin/100 ml), a third bacterial culture was performed. The allogeneic bone is ready. 1, patient preparation Patience and meticulous psychological care before surgery to eliminate patient tension and anxiety, in order to achieve a good match. Shave the hair in the surgical site, and cut the nails in the hands and feet. 2, 109HH artificial tendon selection 1 carcass selection: carcass is a biological fiber, in the shape of a rope. Different types of artificial tendon bodies are selected according to the needs of the surgical site, such as ZBF3-10 and ZBF6-20 for flexion and extension fingers (toe); ZBF6-15 and ZBF6-20 for knee collateral ligament and cruciate ligament; ZBF9 -10, ZBF9-15, ZBF9-20 are used for Achilles tendon. 2 membrane selection: membrane is a specially treated biofilm material. It can be a dry film and a wet film. It has two specifications, namely 5cm×2.5cm×(0.020.12)mm and 10cm×2.5cm×(0.020.12)mm. It can be selected according to the length of the carcass. membrane. 3. Suture: The specially treated biofibrous material can be gradually absorbed by the body in the body. Its specifications are the same as ordinary sutures. Surgical procedure 1. Exposure refers to the proximal fracture of the superficial flexor tendon, and the median incision is made on the ulnar side of the injured finger. The distal end of the deep flexor tendon is found in the middle of the middle finger. 2, select the appropriate length, diameter, special treatment of allogeneic tendon. After taking out from the bottle, it is placed in a 16-20 ° C Ringer's solution for hydration, and it can be applied after 3 hours. 3. The appearance of the tendon after recovery is like fresh tendon. The distal stump was trimmed, the superficial flexor tendon and scar tissue were removed, and the A2 and A4 tendon sheaths were retained. The distal end of the allogeneic tendon was sutured end-to-end. 4. The allogeneic tendon is introduced into the palm wound through the A2, A4 block and subcutaneous tunnel. The proximal end of the allogeneic tendon was transplanted and the proximal flexion of the finger flexor tendon was adjusted. After adjusting the tension, the Kessler method was used to suture the end. 5, after tendon transplantation, flexor tendon recovery tension, the finger is in a normal rest position. Early passive support brace was installed after surgery. 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. Tetanus or gas gangrene may also occur after the injury, and the consequences are quite serious.