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KMID : 0438219770140010187
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Korea University Medical Journal
1977 Volume.14 No. 1 p.187 ~ p.198
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Clinical application of tenorrhapy with the intact flexor sublimis tendon in the laceration of flexor profundus tendon in the matured rabbit, in the region known as "No Man´s Land"
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金光德/Kim, Kwang Duck
邊永壽/Byun, Young Soo
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Abstract
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While great advances have been made in the surgical treatment of the hand in the last two decades, treatment of injuries to the sheath of the distal flexor tendons remains u formidable problem.
Especially troublesome has been the treatment of laceration of flexor profundus tendon with a simultaneously intact flexor sublimis tendon within critical area of pully, so called "No Man´s Land".
Many investigators have tried various techniques in detail compared with others, such as arthrodesis, tenodesis, tendon advancement and tendon graft. Heretofore, because the sutured flexor profundus tendon adhered to the surrounding soft tissue and tendon sheath Post-operatively, active flexion of the distal interphalangeal joint was not achieved.
Author at the Department of Orthopaedic Surgery at Korea University College of Medicine have been performing experimental study on rabbits in which the radical half end of the_ bifurcate flexor sublimis tendon is anastomosed with the distal portion of the lacerated flexor profundus tendon around the area of proximal to middle phalanx.
Then this technique has been applied clinically to a 16 year old Korean boy w110 had been lacerated the 2nd, 3rd and 4th flexor profundus tendon of the Lt hand in the region known as "No Man´s. Land", 1 month after laceration.
The summary of experimental rabbit & .clinical application a-re follows:
1. Experimental rabbit;
Ten adult rabbits with. an average body weight of 2000gm were used.
a. Five. weeks post-operatively; the range of motion on passive flexion of. the DIP and PIP joints was.1W and 21 respectively~. on average as compared with those of 409 and 24 is
normal rabbit.
b. There was no adherence of the united tendon stump with the surrounding tissue.
c. Microscopicall both tendon stumps showed a marked increase of fibroblasts and vascular
proliferation with lympocytic infiltration at 5th weeks after tendon anastomosis.
?. Clinical application;
The follow up result from 3 months to 5 months post-operatively was done.
a. The statio-iary slip o= flexor sublimis tendon flexed the PIP joint while the portion of the flexor sublimis tendon aizstomosed with the flexor profundus tendon flexed the DIP joint.
b. The range of motion with active flexion 5 months post-operatively was as follcws; D´P joint 2nd, 3rd and 4th fingers 7n´, 80´, 77´ and PIP joint o0´, 95´, 90´ respec vY:y. By comparison, the average range of motion of the DIP and PIP joint in normal subjects is 90 and 110 respectively.
c. This operation procedure is thought to be simple, free from complicating adhesion, and economical.
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