What are the parts that need to be paid attention to during the general extensor tendon suture?

Some sensitive parts, some special parts, some joints and some bone vertebrae must be paid attention to and do not make any mistakes. When doing surgery, be sure to clean the wound and eat a light diet.

Attention needs to be paid to the wrists, legs, feet, hands and joints. Because these areas are very important to each of us, we must protect ourselves.

Pay attention to the contraction of the upper limbs, fingers, toes, nerves, muscles, these parts, so that the risk of paralysis can be avoided and the recovery of the later stage can be guaranteed.

Leg joints, elbow joints, lungs, wrist joints, muscles.

Tendon suture surgery process: select appropriate anesthesia, carry out thorough debridement treatment of the wound, remove the pollution, crushed and inactive tissues in the wound, strictly stop bleeding, find the proximal and distal ends of the tendon, and fix it with a syringe needle to prevent the retraction of the broken end of the tendon, take the absorbable tendon suture, suture the broken end of the tendon in alignment, give appropriate reinforcement after suturing to prevent re-rupture, after the suture is satisfactory and firm, give the wound saline irrigation, suture the wound layer by layer, and need to be fixed with a plaster cast or brace for three weeks after surgery. After 3 weeks, the limbs and joints will be gradually exercised.

It is more difficult to perform suture surgery in this area because the whole space that can be operated is relatively small, and the doctor needs to be very careful to keep his hand steady, otherwise there will be deviation.

A ruptured tendon in a finger does not necessarily require surgery.

The method of tendon rupture cannot be generalized, and most tendon rupture requires surgery.

Surgery can restore joint function and restore the continuity of the infrastructure, but there are also some tendon rupture that can be managed conservatively**. If it is an open tendon rupture, there is a wound, there is bleeding, and there is a tendon rupture, then surgery is definitely needed.

Surgery can be debrided, tendons can be sutured, wounds can be sutured, and the corresponding external fixation brace or plaster cast can be added after surgery**. There are two types of tendon rupture, one is traumatic rupture, that is, due to the direct action of violence, resulting in tendon rupture, such as cutting, tearing, etc.; The other is spontaneous rupture, such as a rupture caused by repeated rubbing of the extensor pollicis longus tendon at the site of a wrist fracture.

There are two ways to repair tendons, one is non-surgical**, such as the rupture of the insertion point of the extensor tendon, or the rupture of the Achilles tendon, which can be fixed in the relaxed position of the tendon, such as using a cast or brace, and the fixation will be healed after an appropriate time.

The other is to cut and directly suture the ruptured tendon to repair the ruptured tendon, repair and suture the broken end, and gradually carry out functional exercises after 3-4 weeks to restore the function of the tendon. Early functional exercise can restore joint function well, and at the same time, it can be used to promote blood circulation and remove blood stasis, reduce swelling and relieve pain. There will be some pain and discomfort in finger tendon rupture surgery, but there will be anesthetics during the operation, and there will be no pain, and it can be basically healed about two weeks after surgery, and then slowly strengthen the exercise after healing.

It is recommended that the surgery must be performed in a regular tertiary hospital.

It is suitable for tendon suturing of intrathecal muscles, and has strong tension resistance.

On the basis of the original method, the modified Kessler method adds a circle of seams at the broken end to strengthen the local tensile ability, and at the same time makes the suture smooth and flat.

This method is suitable for tendon sutures with unequal thickness at two broken ends, or tendon sutures with equal thickness at two broken ends, but require greater tension, and the tendon must have sufficient length to be suitable for tendon sutures outside the tendon sheath.

This method can withstand large tension and is not easy to avulsion of tendons, and is suitable for suturing tendons of equal thickness at the two broken ends of flat and wide ends. This is especially true for hand tendons.

The scope of application of this method is basically the same as that of the "8" suture method, and it is mainly suitable for tendons with little tension after suturing.

Stainless steel wire is selected as the suture material to enhance the tensile force, reduce the reaction of the tissue to the suture line, prevent adhesion, and is suitable for those with large tension at the broken end.

Tendon rupture, all should be repaired.

1.The extensor tendon or flexor tendon and tendon sheath were cut by a sharp object in the first stage, the contamination was not serious, the wound was neat, and the injury was within 8 hours after the injury. When the deep and superficial tendons in the flexor tendon sheath rupture at the same time, the superficial tendon can be removed early and the deep tendon can be sutured.

2.If there is no infection in the secondary suture wound, but the patient presents too late, the tendon can be sutured about 3 weeks after injury.

3.Late repair: If the wound is infected, repair should be performed 3 months after the wound has healed.

For open tendon rupture, primary tendon suture should be performed at the same time as debridement, but it is not suitable in the following cases:

tendon contusion and laceration, severe wound contamination;

Patients with tendon rupture and obvious soft tissue blood vascularization disorders;

In some injuries, such as meat processing, fur processing, sewage work, etc., although the appearance of the wound is still clean and the tendon end is relatively neat, it is easy to become infected after surgery.

When suturing the tendon, the two broken ends should be tightly closed, leaving no gap, so as not to heal poorly, or prolong the healing time, but not too tight, too tight will cause the tendon to wrinkle and affect its sliding.

During the whole process of tendon surgery, the operation should be gentle, and after suturing the tendon, in order to prevent adhesions, it should be covered with sutures of the surrounding soft tissues.

When suturing with stainless steel wire, do not twist the wire into a knot, which may affect the suture and the smooth withdrawal after surgery.

Mostly fixed with plaster pads for 3 weeks, after 3 weeks, the plaster fixation can be removed, and gradually start to practice joint activities, supplemented by traditional Chinese medicine decoction water fumigation or physical **.

Postoperatively, the presence of hematoma and infection should be strictly monitored.

The tendons after suturing often have different degrees of adhesions, and for mild adhesions, functional exercises and physical ** can be used; For more severe localized adhesions, tendonolysis may also be performed; For severe adhesions that are extensive, the adhesions can be excised about 3 months after surgery and tendon grafting can be performed.

During immobilization, if the suture of the sudden tendon is loose or there is a sense of loss at the extremity, or if the fingers or toes cannot be extended or flexed after the cast is removed, it means that the sutures of the tendon have fallen off or the tendon avulsion has occurred, and another operation is necessary.

Tendon rupture and defects are common and are often caused by injury or lesion. In order to restore the function of limbs, fingers and toes, ruptured or defective tendons must be repaired with tendon sutures in time. However, almost all repaired tendons have different degrees of adhesions and joint mobility disorders with the surrounding tissues, which are closely related to local pathological conditions, surgical operation techniques, suture materials, and whether the postoperative treatment is correct, and must be paid attention to.