Clinic Research On Modified Suture Method On Preventing Adhesion Of Flexor Tendon

Objective: Flexor tendon injuries are very common in clinic.Adhesion of flexor tendon is one of the most common complications,which is also one of the problems urgently to be solved in hand surgery.Blood supply and the involvement of lymph are two major forms to nourish the tendon.There are two major form of the healing of the tendon: endogenous healing mechanism and exogenous healing mechanism,which both existing at the same time.When the endogenous healing mechanism in the dominant position,there are less possibility of happening of the adhesion of flexor tendon.So the key point of preventing adhesion of flexor tendon is to promote endogenous healing mechanism in the dominant position.Early researches show that early postoperative functional exercise can effectively prevent the adhesion of flexor tendon,which requires higher biomechanical strength.Compared with the grasping suture method,the biomechanical strength of locking method is higher,which can satisfy the need of early postoperative functional exercise.In order to resolve the adhesion of flexor tendon,this paper proposes a modified suturing method on preventing adhesion of flexor tendon,which named ZM tendon suture method.ZM tendon suture method chooses 3-0TICRON polyester suture and adopts early active postoperative functional exercise,which aimed to evaluate the clinical effect of ZM tendon suture method on preventing the adhesion of flexor tendon and provides a new technique to prevent adhesion of flexor tendon.Methods: From April 2016 to June 2017,41 fingers of 33 cases of flexor tendon injuries in zone ?,? and ? were chosen by the researchers as the experimental group.In the 33 cases,there are 9 cases accompanied with the nerve vascular injury.Among the 41 fingers,there are 6 thumbs,10 index fingers,9 middle fingers,9 ring fingers and 7 little fingers.There are 28 fingers which both have the flexor digitorum profundus tendon and flexor superficialis tendon injuries.6 injured fingers are the flexor digitorum profundus tendon and 7 injured fingers are the flexor superficialis tendon.All the patients were emergency cases,and were given the emergency one-stage surgical operation.There 2-4 hours after they were injured.ZM tendon suture method with the 3-OTICRON polyester suture were applied in the operation process.All the cases were given regular treatment and the early active postoperative functional exercise under the guidance of the surgeon.The follow-up were carried four times after the operation.And the treatment outcomes of all cases were evaluated according to TAM(Total Active Motion)standard.Results: 32 cases healed in the first-stage,while one case appeared some inflammatory response which did not affect the final result.All the cased were followed up after the operation and the follow-up rate reached 100%.The superior rate of all the cases was 42.3% in the first month after the operation.The superior rate of all the cases was 97% in the second month after the operation.And the superior rate of all the casesreached 100% in the third month after the operation.There are no postoperative complications and no secondary flexor tendon injuries.Conclusions: Based on the investigations of this paper,it can be concluded that in preventing the adhesion of flexor tendon aspect,ZM tendon suture method,which uses the 3-0TICRON polyester suture,has more advantages.Therefore,we believe that ZM tendon suture method is a practical,reliable and applicable suture method.