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我们应该修复肌腱撕裂伤吗
原作者: Michael Bond, 葛赟译, 文章来源: 《中华急诊医学杂志》编辑部 发布日期:2015-01-25

Title: Should we repair Tendon Lacerations
题目:我们应该修复肌腱撕裂伤吗
Author 作者: Michael Bond
翻译:葛赟 校对:肖锋

。Flexor tendon lacerations have historically not been repaired by emergency providers due to the extensive pulley systems involved and possibility of loss of mobility from scarring.
急诊医生传统上对屈肌腱撕裂伤不进行修复,因为它有广泛的滑轮系统和瘢痕形成可能会失去活动能力。
However, if both ends of the tendon can be visualized in the ED it is not unreasonable to place 1 or 2 horizontal mattress sutures between the two ends to prevent retraction of the proximal portion which can make a formal repair more difficult.
然而,如果在急诊科,肌腱两端已暴露,对两端进行1-2针横褥式缝合来防止近端的收缩并不是不合理的,因近端肌腱收缩会使常规修复更困难。
These injuries have a very high complication rate so most will defer to a hand surgeon for definitive treatment。这些损伤有更多的并发症,因此多数都被转诊给手外科医生做最终治疗。
•Extensor tendon lacerations can be repaired by emergency providers.
•伸肌腱撕裂伤可以由急诊医生进行修补。
Most often these repairs are limited to 6-8. 大部分修复限制在6-8小时内。
See image at 看图 http://www.boneandjoint.org.uk/content/focus/extensor-tendon-injury
One technique is to use a running horizontal mattress suture with non-absorbable nylon sutures. 
一个方法是使用非吸收尼龙缝合线进行连续横褥式缝合。
The ultimate strength of the repair is dependent on the number and size of the sutures placed.
最终修复的强度取决于缝线的数目和号码。
Careful placement of the sutures can prevent gap formation between the ends when the tendon is stressed.
当肌腱绷紧时,认真的缝合能降低断段之间的缝隙形成。
A good discussion on tendon repairs can be found at 
这个链接是一个很好的肌腱修复的讨论http://www.boneandjoint.org.uk/content/focus/extensor-tendon-injury
A reasonable approach to all tendon lacerations is to loosly reapproximate the wound and splint the hand in the position of function until the patient can be seen by a hand surgeon in the next 1-3 days.  These injuries do not require immediate surgical repair, and with the high rate of complications it is probably best to discuss with your hand surgeon before attempting a repair.

对所有肌腱撕裂伤的一个合理治疗方案是将伤口松弛缝合后进行功能位夹板固定。保证病人在3天内看上手外科医生。这些损伤不需要立即进行外科修复,因为并发症发生率高,在想要做修复之前,最好和你的外手科医生尽沟通一下。

References 参考文献:
Wheeless Textbook of Orthopaedics.  http://www.wheelessonline.com/ortho/extensor_tendon_lacerations

文章来源:《中华急诊医学杂志》编辑部