Deep flexor tendon insertion reconstruction

The tendon injury of the hand is mostly open, with more cuts, often with neurovascular injury or bone and joint damage, and a closed laceration can also occur. Refers to deep flexor tendon rupture, manifested as the distal interphalangeal joint can not flex. Treatment of diseases: tendonitis, hand tendon injury Indication It is suitable for the distal volar injury of the middle segment of the right index finger, and the distal segment cannot actively flex. 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 1. Pull the tendon back into place and use a needle to cross the tendon to control retraction. 2. Open the distal tendon and make a wound on the cortical bone at the stop point of the tendon. The proximal end of the broken jaw was made of "8" suture with a diameter of 0.2 cm stainless steel wire. 3. Pass the ends of the wire from the phalanx and the sides of the nail to the back of the finger. Tighten the wire to insert the proximal end of the tendon into the cortical wound. 4. The ends of the wire are ligated on the gauze roll and the rubber sheet to fix. 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.

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