摘要
解剖６只新鲜尸手，观察Ａ４滑车与指浅屈腱分裂带及其相互关系，设计了两种重建Ａ４滑车的方法：（１）双分裂带并列法，即将两条分裂带残端并列缝向对侧滑车残端及分裂带止点；（２）单分裂带环绕法，用一条分裂带环绕屈指深腱一圈半缝向对侧滑车残端及分裂带止点。解剖测试重建的Ａ４滑车与原滑车效能相同。自１９８７年，将上述两法用于临床１８例２０指，ＴＡＭ法评定，优１１指，良６指，可２指，差１指，优良率８５％。利用指浅屈腱分裂带止点与Ａ４滑车止点相邻近的解剖特点，将分裂带残端缝向对侧即可重建一个坚强而有效的Ａ４滑车。双分裂带法适应于指浅屈腱残端拟切除者。切断一条分裂带重建Ａ４滑车对指浅屈腱功能无显著影响。
SixfreshcadaverichandsweredissectedandtheirrelationshipbetweenA4puleyandthedistalsegmentsofflexordigitorumsublimis(FDS)wereobserved.TwokindsofA4puleyreconstruc-tionwiththedistalsegmentofFDSweredesigned.Namelytwinslipreconstructionandunilateralslipreconstruction,thatisutilizationofoneorbothsidesdistalFDStendonslipstowraparoundtheflexordigitorumprofundustendonandanchortotheremanantofthepuleyoriginontheoppositeside.Biomechanictestshowsthatthepuleyeffectsareaboutthesamebetweenthenaturalandreconstructedpuley.Thesetwomethodshavebeenusedin18caseswith20digitsclinicalysince1987.EvaluationbyTAMsystemshowsexcelentin11digits,goodin6digits,fairin2digitsandpoorin1digit.Theexcel-lent/goodrateis85%.PuleyreconstructionwithdistalsegmentofFDSisindicatedincaseswithinten-tionofexcisionoftheremnantofFDS.SacrificeofterminalslipononesidewouldnotbringobviousfunctionalimpairmenttotheFDS.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1996年第6期381-383,共3页
Chinese Journal of Orthopaedics
关键词
指浅屈腱分裂带
滑车
重建
解剖
FlexordigitorumsuperficialisslipsPuleyKeconseructionAmatomy
