extensor tendon suture, zone III

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: tendonitis, 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. Extend the original wound into a longitudinal "S" shape, revealing the total extensor tendon, and see that the broken end is neat and intact, the proximal end of the broken tendon is about 1.0 cm from the distal edge of the transverse ligament of the wrist, and the ligament is removed by 1.5 cm. Open the joints of the muscles to prevent the tendon from slipping and reduce the chance of adhesion. 2, suture each broken piece with 3/0 non-invasive needle thread "8" shape. 3. Close the wound. Use a plaster to hold the wrist and fingers over the extension for 4 weeks. 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.