摘要目的 评价V区屈指肌腱修复后的功能并分析影响功能的有关因素. 方法 对2003年9月-2009年7月收治的52例(163指)腕前区涉及V区屈指肌腱损伤患者的临床资料进行回顾性分析,术后随访平均32个月,采用三种不同束数的腱缝合法缝合肌腱.测量患指关节主动活动度、握力、捏力,检查患指指浅屈肌腱( flexor digitorum superficialis,FDS)独立运动功能,并采用上肢功能评定量表(disability of arm,shoulder and hand,DASH)评分.对V区屈肌腱损伤平面、 缝合方法 、手术者的经验和肌腱损伤复合程度等影响因素进行统计学分析. 结果 随访163指中,146指(89.6％)获得优或良的关节活动度,147指涉及FDS损伤中,103指(70.1％)获得独立的FDS运动功能；握力、捏力平均恢复到健侧的2/3,DASH平均11.9分.采用2束Kessler法缝合组、手术者经验级别低组以及复合损伤严重组的术后功能要明显差于各自对应的其他组(P＜0.05),损伤不同平面对功能结果 影响不大(P＞0.05). 结论 V区屈肌腱损伤修复后功能恢复良好,缝合方法 、手术者的经验和复合损伤的严重程度对功能有明显影响；提高手术者的经验可有效改善术后功能.

abstractsObjective To evaluate the functional outcome after repair of zone V flexor tendon and to identify the relevant factors affecting the outcome. Methods A total of 52 patients ( 163 fingers) with wrist lacerations involving zone V flexor tendon from September 2003 to July 2009 were retrospectively studied.The average follow-up period was 32 months.The lacerated tendons were repaired by using three suture methods of different strands.Functional outcome was assessed by determining the active range of motion (AROM),and grip and pinch strength of the injured fingers,testing the independent flexor digitorum superficialis (FDS) action and employing the disability of arm,shoulder,and hand (DASH) questionnaire.Influencing factors for function of the repaired tendon including laceration section levels,repair methods,surgeons' experience,and injury severity were analyzed statistically. Results Functionally,146 out of 163 fingers (89.6％) achieved excellent or good range of motion and 103 out of 147 fingers with FDS injury (70.1％ ) obtained independent FDS action.Grip and pinch strength recovered to about two-thirds of the uninjured level.The mean DASH score was 11.9.Patients had adverse functional outcorme in tendons repaired with the 2-strand Kessler,in the tendons repaired by the surgeons with low level of expertise,or in the wrists with "Spaghetti" injuries,but levels of laceration section had no significant influence on the outcomes. Conclusions Functional recovery of zone V flexor tendon injuries is generally good,but repair methods,levels of expertise of surgeons,and injury severity have significant influences on the outcome.Thereby,advanced levels of expertise of surgeons can effectively improve the postoperative function.