Suture of extensor pollicis longus tendon, zone III-IV

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. This article describes the commonly used tendon suture method and its technique. Treatment of diseases: hand injury, flexor 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. Tendons with small or small diameters can be sutured with Nilon monofilament. Filament thread suture has a certain degree of tissue reaction, mostly used for Bunnell burial suture, but the silk thread must be able to withstand 1 to 1.5 kg of tensile force. 5. Prepare a slender straight round needle for suturing the tendon. Surgical procedure The left hand has a slight cut injury on the side of the hemiplegia, and the thumb cannot actively extend straight. Long extensor tendon rupture, zone III. An "S"-shaped incision was made along the extensor tendon of the thumb. It was found that the extensor tendon of the thumb was fractured at the distal edge of the transverse ligament of the wrist, and the proximal end was removed from the Lister nodule. Clean up the back end and the scar on the trampoline. Because of the large difference between the thickness of the two ends, the 5/0 needle thread is used for the knitting stitching. Close the wound. The extensor tendon of the thumb has recovered tension. The plaster brake wrist and thumb are overstretched for 4 weeks.