常见问题:肌腱修复

伸肌腱(手和手臂背面的肌腱)受伤通常是由于割伤或当手指受到明显的卡塞力而导致腱从其骨附着处撕裂或断裂时引起的。这导致功能障碍以及解剖畸形。

伸肌腱是位于皮肤下面的肌腱,沿着手臂的后侧向下进入手和手指。它们起到拉直手腕,手指和拇指的作用。

Extensor tendon injuries often cause functional impairments as well as anatomical deformities. Functional impairments result in an inability to straighten/raise your wrist or straighten your fingers in your hand. The most common anatomical deformities in extensor tendon injuries is mallet fingers or boutonniere deformity.

  • There are multiple ways to treat an extensor tendon injury depending on the age of the injury, mechanism of injury and the location of the injury
  • Splinting – the injured finger is placed into a splint to straighten the finger and allow the ruptured tendon to scar down and restore the function of the finger
  • 手术修复–将切断/断裂的肌腱的两端相对并拢并缝合时。进行手术修复后,通常需要将其放入石膏中以保护手术修复。
  • 销钉–除夹板/铸件之外,您可能还需要在接头空间上放置一个别针,以稳定接头,以帮助腱愈合。

根据受伤的部位,受伤的机理和受伤的年龄,您可能需要进行手术矫正或用手指钉扎,以帮助恢复受伤的手/手指的功能。

Surgical repair attempts to bring the two ends of the ruptured/cut tendon back together in hopes that it can restore the function and dexterity in the finger. This surgery attempts to bring the two ends of the ruptured/cut tendon back together in hopes that it can restore the function and dexterity in the finger.

Common surgical risk include non-union of severed tendon, injury to nearby nerves and vessels, and wound infections. The most common complication to this surgical intervention is extension lag and loss of flexion. This is often due to the scarring that occurs from the surgical repair. Additionally, there could be a loss of ability to flex the finger or a diminished angle of flexion as a result of scaring from the surgery.

有关可能出现的并发症的更全面列表,请访问Colin Hong博士的网站,网址为: http://www.drcolinhong.com/learn/risks-and-complications/extensor-tendon-repair

非手术选择包括根据受伤的类型和复杂程度,将夹板或铸成受伤的手/手指。如果肌腱破裂包括腕骨骨折,并且骨折或脱位不稳,则外科医生可能会选择在重新对准后再将手夹在适当的位置,然后将手放到石膏中。但是,根据受伤年龄的不同,最合适的处理方法可能有所不同。

取决于受伤的伸肌腱的位置,可以应用不同的手术技术来修复受伤的肌腱并帮助恢复由于肌腱损伤而丧失的功能。

其他手术修复可能包括肌腱转移以帮助促进功能,或者如果无法近似受伤的肌腱末端,则进行肌腱移植。肌腱移植物是从手臂的另一条肌腱或脚踝(分别为长趾肌和plant肌腱)收获的。

建议尽快进行手术,因为延迟治疗可能会在受伤部位造成更多的疤痕,从而使保守治疗变得更加困难,而且夹板也会增加技术难度。

建议尽快处理伸肌腱损伤。拖延治疗可能会在受伤部位造成更多的疤痕,从而使采用夹板的保守治疗更加困难,并使手术在技术上更加困难。

如果您选择不对伸肌腱损伤进行任何处理,则可能是您的手指/手部受伤后持续出现功能丧失和解剖畸形。

根据受伤的年龄,选择延迟治疗可能导致无法保守地处理损伤(无手术/钉扎),进一步的延迟也可能使手术在技术上更加困难,失败的可能性更高,或者需要更多复杂的手术修复的损伤。

您的手部外科手术是通过在皮肤上切开切口来进行的。

当手部复杂受伤,骨头丢失或手部骨骼不稳定骨折时,需要使用骨移植物和钢板。是否需要这种管理取决于手受到的伤害类型。

根据受伤肌腱的大小(直径)和受伤部位的不同,收获肌腱通常来自前臂或小腿区域。

手术后,您将立即被放置在石膏中以保护修复。此演员表可能会持续4周。然后,根据受伤情况,您将被置于动态夹板中,或者可能需要连续夹板,以便缓慢地向受伤的关节施加运动。从长远来看,通过理疗和伸展运动,大多数患者的关节活动范围和强度都会提高到以前功能的约80%

Symptoms may reoccur if you re-injure the hand or cause a second rupture. As the strength of the tendon is now weaker. The exact reoccurrence rate is unknown. Symptoms may reoccur if you re-injure the hand or cause a second rupture as the tendon is now weaker. The exact reoccurrence rate is unknown.

The incision will likely be above the region of the rupture tendon and can range in length depending on the amount of tendon retraction there is from initial injury.

您的疤痕将取决于受伤的程度和复杂程度。如果腱断裂/撕裂与骨折相关,则修复可能会更广泛,并且疤痕会更大。如果可能的话,沿着自然的折痕和平面切开切口,以便在美学治愈后将切口隐藏起来。

手术的持续时间取决于损伤和手术修复的复杂程度。

该手术通常不需要输血,因为失血量最少且在门诊进行。但是,如果您的伤口是慢性损伤,需要在手术室进行复杂的手术干预,则将检查您的血型,以防出血量比平时多,并且需要输血。对于复杂的手术室病例,获取血型是所有病例的标准程序。

You will likely need to be casted after surgery for 4-6 weeks. Depending on the complexity of injury, it may be appropriate after a couple weeks for you to be placed into a splint for serial splinting (to progressively change the degree support you require) or placed into a dynamic splint.

Pain after surgery can vary depending on the complexity of the injury and surgical repair.

We usually recommend you to take Acetaminophen (Tylenol) and/or Ibuprofen (Advil/Motrin) after surgery. You may need some prescription pain medication which will be prescribed for you after surgery.

Usually, there is no tubes or drains placed after surgery if the repair is in the hand. Larger and more extensive repairs in the arm may require a drain placement. The drain is usually left in place for 2-3 days.

You will need physical therapy after surgery, as this is the most essential part to the recovery process. Physical therapy session will start after the cast is removed and you may need several sessions for the following weeks to month of surgery.

You likely will not need any crutches/boots ater surgery, unless the repair is in your leg.

Usually, this is an outpatient procedure and you will not need to stay in the hospital. Howecer, if the surgery is extensive, you may need to stay overnight.

It will likely take 6-8 weeks with physiotherapy to regain the range of motion and can take up to 4-6 months before the repaired tendon is back to full strength. But it can take up to six months to regain the full range of movement. In some cases, it may never be possible to move the affected finger or thumb as much as before it was damaged.

You will be placed in a cast, your arm is protected for further injury, but it is recommended that you stay away from contact sports and water activities. After your cast is removed and you begin to regain strength, your level of activity will be modified.

Depending on the injury and repair, some patients are able to drive. However, with the cast on, some individuals find it cumbersome and difficult to drive safely. Additionally, it is recommended that you do not drive while taking any prescription pain medication.

Most patients will take a week off work, but some people elect to return to work prior to that. If your cast does not interfere with your work, you can return to work 1-2 days after your surgery. However, if your workplace requires significant manual dexterity, you might need to modify the work you do during the recovery process.

If your procedure is an outpatient procedure performed in the ambulatory clinic, you will be receiving local anesthetics to numb/block sensation in the hand for a short duration. However, if your repair is extensive and it is done in the operative room, you may need general anesthesia where you a put to sleep.

If your procedure is complex and requires general anesthesia, you will need to see an anesthesiologist for evaluation prior to surgery.@@@If your procedure is complex and requires general anesthesia, you will need to see an anesthesiologist for evaluation prior to surgery. This will be set up after your initial consultation and surgical date is set.

Your medication list will be reviewed prior to surgery. However, you should also review your medication with your family doctor as well.

Generally, blood thinners should be stopped prior to surgery. However, different types of blood thinners should be stopped for different durations prior to surgery. Your family physician should be consulted as to when and if you should stop your medication prior to surgery.

Typically, no other tests is required prior to surgery as extensor tendon injury is diagnosed by symptoms experienced by the patient. However, certain individuals on specific types of blood thinners may need a blood test immediately prior to surgery.

If you are scheduled for surgery in the ambulatory clinic, there are no diet and fluid restrictions prior to or after surgery. However, if your surgery is scheduled to be in the operating room and you’ve seen anesthesiologist for general anesthesia, you will need to stop eating/drinking at midnight the evening prior to your surgery.

You can shower with antibacterial soap the evening prior to or the morning of your surgery. This is only needed if your surgery is scheduled to happen in the operating room.

If you are having surgery in the surgical clinic, you should arrive at your appointment time for surgery. <br>If you are scheduled to have surgery in the operating room, there should be an appointed time for you to arrive in your information package given to you during your consultation with the anesthesiologist.

Please call the office at (416)222-6986 to see your scheduled date and time for your surgery. This surgery is usually performed at two different hospital sites: Mackenzie Health Center or Rouge Valley Centenary Hospital. Once your appointment is set, you will be directed to the correct site.

You will likely need someone to drive you home after surgery as driving with a cast maybe cumbersome at first and require some time before you get used to having the cast on your hand.

  • 安排住院期间可能需要的个人物品
  • 安排某人在家里和工作中承担责任
  • 安排某人带你回家医院
  • 安排一个人在手术后的第一天和你在一起
  • Arrange for someone to help you with your daily routine for as long as you may need after surgery
  • 如果您有其他疑问,请致电您的医生
  • 如果您在手术后10天内生病(即使是小病,例如感冒),请通知医生
  • 按照医生的建议停止进食和/或饮水
  • 手术前24小时请勿吸烟或饮酒
  • 确保您拥有医生的联系信息
  • 确保您有访客前往医院/办公室的指示
  • Make changes to your living space that will make it easier for you to access the things you may need while recovering
  • Arrange for any special equipment you may need after surgery

The duration of the surgery is determined by the location, extent of injury and the complexity of the surgery. Surgery can range from 30min to several hours depending the surgical intervention implemented.

If your surgery is done in surgical clinic, you are typically awake for the whole procedure. However, if your surgery is complex and require general anesthesia, you will be asleep for the whole procedure and for an additional hour in recovery.

If the surgery is done in surgical clinic, your friend/family member can accompany you in the room during the surgery if they feel comfortable. If you require general anesthesia, you friend/family member will usually be able to come see you in the recovery room after you’ve completely waken up from anesthetics.

Typically for surgery performed in surgical clinic, no medication is needed to prevent blood clot formation. This is usually the same case for patients who have their procedure in the operating room and are discharged the same day of surgery. However, you if you stay in the hospital after surgery and/or if you are unable to mobilize after surgery, we may give you some blood thinners to prevent the formation of blood clots after surgery.

For procedures done under local anesthetics, no antibiotics is needed for surgery. If you require general anesthesia, we generally give one dose of antibiotics prior to surgery. You will not need antibiotics after surgery. If you injury is fresh and complex and the damage to your tendon is due to an open laceration, you may receive a course of antibiotics.

  • For procedures done under local anesthetics, no antibiotics is needed for surgery.
  • If you require general anesthesia, we generally give one dose of antibiotics prior to surgery. You will not need antibiotics after surgery.
  • If your injury is fresh and complex and the damage to your tendon is due to an open laceration, you may receive a course of antibiotics.

  • 确保已通过姓名和出生日期确认您的身份
  • 确保您已确认要进行的手术
  • 确保已标出正确的手术部位
  • 确认您可能有的任何过敏和副作用
  • 确保您了解并签署了知情同意书

Unless your surgeon specifically says otherwise, your surgery went according to plan without complications. Success of the surgery depends on post-operative management such continual stretching and exercises when the cast is removed.

Usually, you will not be placed on any antibiotics after surgery. However, if the ruptured/injured tendon is a result of an open laceration, you will be placed on a dose of antibiotics and it is commonly prescribed for 7-10 days.

With the exception of blood thinners, most prescription drugs do not need to be stopped and can be continued throughout the day of the procedure. Blood thinners can be restarted after surgery.

Prevention of blood clot formation is only needed if you are admitted into the hospital after your surgery or if you will be immobilized after surgery (i.e. if you have a tendon repair on the foot/leg). Otherwise, we will no need to implement any preventative measures for blood clots for outpatient procedures.

If you require general anesthesia, you will need to stop drinking/eating at midnight, the night before surgery. If your surgery is performed in day surgery or surgical clinic, there is no restrictions to eating or drinking

You will need to do breathing exercises only after you have surgery in the operating room. Your nurse will remind you how to do the breathing exercises after your surgery. If your procedure occurs in the outpatient clinic and you do not have general anesthesia, no breathing exercises is needed after surgery.

Usually this is performed as an outpatient procedure, even when your procedure is scheduled to be done in the operating room. However, if your surgery is complex, you may need to stay overnight at the hospital for 1-2 days.

You need to be stable and can demonstrate that your pain is under control before you are discharged. Usually, pain medications is prescribed to you if needed. Additionally, you may experience some nausea after surgery from the anesthetics, thus you have to be able to drink and keep down water prior to being discharge.

For minor surgical procedures we usually recommend that the patient take acetaminophen (Tylenol) and/or ibuprofen (Advil/Motrin). Sometimes for more extensive procedures, you may be given a prescription for stronger pain medications.

Typically you will need to start physiotherapy exercises when the cast comes off your arm. Sometimes, depending on the complexity of injury, you may need to start physiotherapy earlier. This will be organized for you after your surgery.

Your prescription medications will be given to you upon discharge from the hospital or after your surgery.

After surgery, you should be able to resume all your medications. If there are any specific medications you need to avoid, you will be notified by your team.

You can take a shower the evening after your surgery, taking care to not get your cast(s) wet.

You will need to return for a follow up appointment 10-14 days after surgery. You will also be set up for a physiotherapy appointment prior to your discharge.

Yes, you will have sutures/staples/pins that will need to be removed after surgery. The appropriate time for these to be removed depends on your specific condition.

Usually the cast is removed after 4-6 weeks.

Depending on your specific surgical intervention, you may have a cast on your ankle after surgery if there is a tendon harvest from your heal. You may also need crutches to maneuver around after surgery. Additionally for the repair in the hand, you may have a cast for 4-6 weeks followed by splints as you recover.

If you pain is control, your activity can be as tolerated after surgery.

Depending on the complexity of your surgery, you may return to work as soon as 1-2 days after surgery or 3-4 weeks after surgery. You may need some of your tasks at work to be modified for some time during the recovery process.

This is dependent on the complexity of the injury and surgery. It is advised that you have a friend/family member drive you home after surgery. Additionally, driving and operating heavy machinery should be avoided if you are taking any prescription pain medications.

There is no restrictions to sexual activity after surgery.

  • 确保护理人员在护理前后洗手
  • 不要等到剧烈疼痛才需要止痛药
  • 在医护人员离开房间之前,请确保通话按钮触手可及
  • 站起来之前,请坐在床边几分钟,以免头晕
  • 如果您感到虚弱或头晕,请勿在没有帮助的情况下起床
  • Do not put weight on your affected foot as long as advised by your doctor
  • 您发烧高于华氏100.4度
  • 您呼吸急促或胸痛
  • 您会发现手术切口周围发红,肿胀,发热或疼痛加剧
  • 您会注意到切口正在分离,或者切口中已感染了分泌物
  • You notice that the skin on your affected foot is pale or has an unusual color
  • You are unable to move the toes on your affected foot
  • You cannot feel the toes on your affected foot
  • 您有您现有的止痛药无法控制的疼痛
  • 遵医嘱服用止痛药和其他药物
  • 服用处方止痛药时请勿开车
  • 手术后十天不要泡澡或游泳
  • 保持切口清洁干燥
  • Keep your foot elevated when sitting or lying down and apply ice to it to reduce swelling as advised by your doctor
  • Follow your doctor’s instructions on caring for your cast and foot
  • Follow your doctor’s instructions regarding putting weight on the affected foot
  • Attend physical therapy appointments as long as advised by your doctor
  • 只要医生建议,就避免剧烈运动和繁重的举动
  • 按照医生的指示恢复正常的日常活动
  • 按照医生的指示恢复性行为

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