在屈肌腱修复过程中释放滑轮是“不可或缺的一部分”吗?对当前证据的叙述性回顾。

IF 1.5
Amir Abdelmalek, John McFarlane
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引用次数: 1

摘要

背景:复杂的手屈肌滑轮系统是必不可少的,以实现有效的屈肌腱的功能。先前的尸体研究表明,A2和A4是维持正常手指生物力学的关键滑轮。实际上,在修复1区和2区屈肌腱撕裂时,保留A2和A4滑轮是极具挑战性的。我们在这篇文章中回顾了目前发表的证据,以回答释放滑轮是否会导致弓弦或影响临床结果的问题。方法:对现有数据库进行文献检索。结果:没有发表的比较证据。回顾性病例系列报道,在屈肌腱修复期间释放屈肌滑轮后,没有临床弓弦现象。根据Tang和/或Strickland评估活动范围(ROM)的标准报道了结果。没有手功能评分或患者满意度评分的报道。结论:根据有限的现有证据,在肌腱修复期间释放屈肌滑轮以允许进入或防止修复肌腱的撞击似乎不会引起弓弦或影响结果。需要进一步的研究。证据等级:四级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Is releasing pulleys during flexor tendon repair "part and parcel"? Narrative review of the current evidence.

Background: The complex hand flexors pulleys system is essential in achieving efficient flexor tendons' function. Previous cadaveric studies demonstrated that A2 and A4 are the crucial pulleys in maintaining normal digits biomechanics. Realistically, the preservation of A2 and A4 pulleys during repairing flexor tendon laceration in zones one and two can be extremely challenging. We review the current published evidence in this article to answer the question of whether releasing the pulleys cause bowstringing or affects clinical outcomes.

Methods: Literature search of the available databases.

Results: There was no published comparative evidence. Retrospective case series have reported that no clinical bowstringing was noted after releasing flexor pulleys during flexor tendon repairs. Outcomes have been reported according to Tang and or Strickland criteria to assess range of motion (ROM). No functional hand scores or patients' satisfactions scores have been reported.

Conclusion: Releasing flexor pulleys during tendon repair to allow access or prevent impingement of the repaired tendon does not seem to cause bowstringing or affect outcome based on the limited available evidence. Future research is needed.

Level of evidence: Level 4.

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