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Beugesehnentransplantation

Flexor tendon transplantation

  • Leitthema
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Der Orthopäde Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Die Insuffizienz beider Beugesehnen eines Fingers stört die Funktion der ganzen Hand erheblich. Die Beugesehnentransplantation stellt in vielen Fällen die beste Möglichkeit zur Rekonstruktion oder Funktionsverbesserung dar.

Fragestellung

Anhand der Literatur und eigener Ergebnisse werden der aktuelle Stand der Operationstechnik, aber auch die Möglichkeiten und Gefahren dieser aufwendigen Operation dargestellt. Die Kenntnis von Alternativverfahren ist wichtig bei der Indikationsstellung.

Patienten und Methode

Aus dem eigenen Krankengut wurden in mehreren Etappen aus dem Zeitraum von 1974 bis 2000 insgesamt 272 Patienten nach 2–12 Jahren nachuntersucht.

Ergebnisse

Ähnlich wie im internationalen Vergleich erweisen sich die Langzeitergebnisse unseres Krankenguts unabhängig von der Operationstechnik (gestielt oder frei) nach dem Buck-Gramcko-Score als 32 % sehr gut, 26,4 % gut, 15 % befriedigend und 26,5 % schlecht.

Schlussfolgerungen

Aufgrund der zahlreichen Details, die vor, während und nach der Operation beachtet werden müssen, und der in vielerlei Hinsicht enormen Tragweite für den Patienten sollte diese Operation erfahrenen Handchirurgen überlassen werden.

Abstract

Background

Insufficiency of both flexor tendons of a finger considerably disrupts the function of the whole hand. Flexor tendon transplantation represents the best way to reconstruct or improv function in many cases.

Objectives

Based on the literature and our own results, not only the current state of the surgical technique, but also the opportunities and dangers of this sophisticated operation, are represented. Knowledge of alternative methods is important.

Methods

With a follow-up of between 2 to 12 years, a total of 272 patients who underwent flexor tendon transplantation in the hand during several periods from 1974 to 2000 were investigated.

Results

Similar to the international literature, our long-term results did not specify the exact surgical technique (pedicled or free). According to the Buck–Gramcko score, 32 % had very good results, 26.4 % good, 15.1 % satisfactory, and 26.5 % poor.

Conclusions

Numerous details need to be considered before, during, and after surgery. For the patient, the procedure has tremendous significance in many ways; thus, this operation should only be performed by an experienced hand surgeon.

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Authors and Affiliations

  1. Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Waldeyerstr. 1, 48149, Münster, Deutschland

    M.F. Langer, B. Wieskötter, K. Herrmann & S. Oeckenpöhler

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  1. M.F. Langer
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  2. B. Wieskötter
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  3. K. Herrmann
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  4. S. Oeckenpöhler
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Correspondence to M.F. Langer.

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M. F. Langer, B. Wieskötter, K. Herrmann und S. Oeckenpöhler geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Langer, M., Wieskötter, B., Herrmann, K. et al. Beugesehnentransplantation. Orthopäde 44, 777–785 (2015). https://doi.org/10.1007/s00132-015-3156-2

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