Comparison Of Clinical Effects Between Tsuge Suture Combined With Modified Kessler Suture And Double Modified Kessler Suture To Repair Flexor Tendon Injury In Zone ?

Objective:To retrospectively analyze the differences in clinical outcomes between Tsuge's suture combined with modified kessler suture and double modified kessler suture to repair flexor tendon injury in zone ?,and explore its significance.Methods: Collecting patients who were diagnosed with flexor tendon ? injury and hospitalized in our hospital from December 2016 to October 2018,retrospective analysis of patients who met the criteria of diagnosis,inclusion,and exclusion,44 cases,51 fingers,both tendon fractures due to cutting injuries,according to the stitching method,it is divided into two groups,A and B,among them,group A: 23 cases of 27 fingers,Tsuge suture combined with modified kessler suture method,group B: 21 cases of 24 fingers,double modified kessler suture method.Both groups were treated with surgery within 8 hours after the injury.The same early protective functional exercise was performed after the operation,and the hand was fixed at the same position after the operation.Compare the suture time of the tendon in both groups;the level of recovery of finger function was assessed according to the TAM(Total Active Movement)assessment method at 4,8,and 12 weeks after surgery;at the same time,the complications of the patient's postoperative fingers(whether the tendon is broken again or not,and whether the wound is infected)are recorded.Statistical analysis was performed using SPSS 21.0 for statistical analysis.Results: 1.The general data of the two groups(age,gender,location,injury index),P>0.05,the difference was not statistically significant.2.The time of suturing tendon was compared between the two suture methods.P<0.05,the difference was statistically significant,and the time to suture tendon was shorter in group A.There was no re-rupture of tendon after operation in group A.There was one case of tendon re-rupture in group B,P>0.05,and the difference was not statistically significant.There was no wound infection in group A.There were 2 cases of superficial wound infection in group B,P>0.05.The difference was not statistically significant.3.The TAM assessment criteria were used to assess the functional activities of the injured finger at 4,8,and 12 weeks after surgery,and the functional activity of both groups was improved,in group A,the recovery of the injured finger at 4th and 8th week was significantly better than that of group B,the difference was statistically significant,P<0.05;at the 12 th week after surgery,there was no significant difference in recovery between the two groups,P>0.05.Conclusion: In the flexor tendon ? area tendon injury,the Tsuge suture combined with modified kessler suture and double modified kessler suture combined with functional exercise can achieve better long-term clinical effect,but the early clinical treatment of the former is better.And the Tsuge suture combined with modified kessler suture method is simpler than the double modified kesslerr suture method,which can shorten the operation time,reduce the clamping of the tendon and reduces blood supply to the tendon,and the surrounding soft tissue are less damaged.The Tsuge suture combined with modified kessler suture method is a suture method with strong anti-tension and short suture time,which is worthy of clinical promotion,but it requires special ferrule sutures,in the absence of ferrule sutures,the selection of double modified kessler suture method can also yield better results.