Seventeen cases involving 18 fingers of acute rupture of flexor tendon within the Zone Ⅱ were repaired by microsurgical technique for reconstructing the digital sheath with biological membrane since 1989. The excellent/good rate based on Eaton grading was 89%. The main procedure of the operation. the early postoperative rehabilitation and active excercises were described.
OBJECTIVE: To investigate the effects of chitosan membrane on tendon adhesion and healing and obtain experimental data for clinical use in preventing postoperative tendon adhesion. METHODS: The long flexor tendon of 55 adult legborn hens were cut and sutured encapsulated by chitosan membrane. Movement and anti-tension capability of tendon were assessed at 2, 4, 6, 8 and 10 weeks after operation by SWD-10 type tendon stretcher. Tendon healing and adhesion were observed with light microscope. RESULTS: Tendon healing could be effected by chitosan membrane within 4 weeks, and tendon anti-tension strength was increased after 4 weeks. CONCLUSION: Chitiosan membrane possesses the following characteristics: no side effects, good permeability, resolvable, absorbable and selective inhibition the growth of fibroblast. It is a desirable biological material to prevent tendon adhesion.
Between 1988 and 1994, 78 cases (183 tendons) of flexor tendon injuries of the hand were repaired by microsurgical techique. The patients were followed up from4 to 6 months. The results were assessed according to the grading method of TAM. In 36 cases, 78 tendons were repaired by microsurgical suture and the excellentgood rate reached 76.2 per cent and the other 42 cases, 105 tendons were repaired with biological memberane wrapped arround the anastomotic site following microsurgical suture, in which, 32 cases, 77 tendons were followed up and the excellentgood rate was 89.5 per cent. The curative effect between the two groups hadsignificant difference statistically (Plt;0.05). Those cases with a bad results were mainly those injuries occurred in Zone II which had very poor soft tissue condition of the palm and thoes old cases having extensive scar tissue formation surrounding the tendon bed.
