摘要
目的探讨改良的尺侧腕伸肌腱联合拇短伸肌腱转位重建拇对掌功能的治疗效果。方法自2013年4月至2016年2月，我们采用改良尺侧腕伸肌腱联合拇短伸肌腱转位手术重建19例陈旧性正中神经损伤患者的拇对掌功能。拇短伸肌腱穿过拇短展肌止点并缝合固定后，在掌长肌腱深层与转位的尺侧腕伸肌腱编织缝合，以掌长肌腱作为屈肌支持带，避免术后弓弦效应为改良特点。术后对患者的恢复情况进行功能评定分析。结果术后所有患者均获得随访，时间3—15个月，平均6．8个月，按朱伟等的功能评定标准进行评定：优14例，良5例。结论改良尺侧腕伸肌腱联合拇短伸肌腱转位重建拇对掌功能，该手术简单易行，符合拇对掌的生物力学特性，术后效果满意，值得推广。
Objective To evaluate the treatment outcomes of reconstructing thumb opposition ftmction by modified combined transfer of extensor carpi ulnaris and extensor pollicis brevis. Methods Between April 2013 and February 2016, 19 cases of old median nerve injury were treated with modified transfer of extensor carpi ulnaris and extensor pollicis brevi to restore thumb opposition function. The surgical modifications included passing the extensor pollicis brevis muscle tendon through the insertion of the abductor pollicis brevis and suturing it there before tunneling it underneath the palmaris longus tendon and weaving it with the transferred extensor carpi ulnaris tendon. The palmaris longus served as a flexor retinaculum to avoid postoperative bowstring. Postoperative functional recoveries were evaluated and analyzed. Results All 19 patients were follow-up for 3 to 15 months postoperatively, the average time being 6.8 months. The functional assessment graded the results as excellent in 14 cases, good in 5 cases. Conclusion The modified combined transfer of the extensor carpi ulnaris and extensor pollicis brevis is simple, and is in accordance with the biomechanics of human thumb. It is an effective surgical procedure that is worth promoting.
出处
《中华手外科杂志》
CSCD
北大核心
2017年第1期47-49,共3页
Chinese Journal of Hand Surgery
关键词
正中神经
腱转移术
拇对掌功能
尺侧腕伸肌腱
Median nerve
Tendon transfer
Thumb opposition function
Extensor carpi ulnaris tendon
