拇长伸肌腱白发性断裂的临床分析及治疗

肌腱自发性断裂是指无明显外伤或仅轻微的动作所引起的肌腱断裂。自发性肌腱断裂的发病率很低，约占手部损伤的0．1％。1998年7月～2004年1月，我们对17例拇长伸肌腱自发性断裂患者的病因进行分析，采用桡侧腕长伸肌腱移位修复，获得满意的疗效。报告如下。     

拇长伸肌腱自发性断裂的临床分析及治疗

肌腱自发性断裂是指无明显外伤或仅轻微的动作所引起的肌腱断裂.自发性肌腱断裂的发病率很低,约占手部损伤的0.1%[1].1998年7月～2004年1月,我们对17例拇长伸肌腱自发性断裂患者的病因进行分析,采用桡侧腕长伸肌腱移位修复,获得满意的疗效.报告如下.     

拇长伸肌腱自发性断裂19例的临床治疗

目的 探讨拇长伸肌腱自发性断裂的病因及治疗方法.方法 2015年5月-2020年1月,采用示指固有伸肌腱转位及掌长肌腱游离移植对19例拇长伸肌腱自发性断裂进行修复.结果 术后19例获随访4～24个月,平均6个月.拇指指间关节背伸0°～5°,屈曲35°～45°.按SEEM评分标准,示指固有伸肌腱移位重建拇长伸肌腱12例,...     

不同原因拇长伸肌腱自发性断裂的治疗

自发性拇长伸肌腱断裂临床不多见，随着中国逐渐进入老龄化社会，其发病呈上升趋势，我院自2000-2005年共手术治疗自发性拇长伸肌腱断裂15例，效果良好，报道如下。     

拇长伸肌腱自发性断裂的诊断与治疗

我院于1990~1998年共收治拇长伸肌腱自发性断裂患者11例12指,经三种不同方法进行修复,取得满意效果。1 临床资料11例患者中男性7例,女性4例。年龄16~55岁。牛奶厂挤奶工人4例,技工2例,裁缝2例,农民2例,干部1例。左手4例,右手6例,双手1例。病史最短者2周,最长5年。11例患者都有不同程度腕背疼痛及活动受限,无外伤史及类风湿关节炎病史。入院时拇指指间关节伸直障碍,对掌困难,术前拍片未见桡骨及腕骨异常。     

食指固有伸肌腱移位修复拇长伸肌腱损伤

拇长伸肌腱损伤临床上比较常见,陈旧性损伤及自发断裂不能直接缝合,我院自2000年7月～2005年8月用食指固有伸肌腱移位修复拇长伸肌腱断裂9例,获得了良好的临床效果,现报道如下。1资料与方法1.1一般资料本组共9例,男8例,女1例,年龄16～52岁,左手5例,右手4例,切割伤2例,自发断裂5     

掌长肌腱移植与示指固有伸肌腱转位治疗拇长伸肌腱自发性断裂的疗效对比

目的 探讨并对比掌长肌腱移植与示指固有伸肌腱转位修复拇长伸肌腱自发性断裂的临床疗效。方法 对2017年2月-2020年12月收治的46例自发性拇长伸肌腱断裂患者,按手术方式分为掌长肌腱移植组与示指固有伸肌腱转位组,术后均予外展背伸位被动支具固定3周,逐步行患指主被动功能训练,定期随访。结果 两组术后均获随访4~8个月,平均5个月。根据TAM评价标准,掌长肌腱移植组与示指固有伸肌腱转位组术后均取得了较为明显的临床疗效,两组在优、良、中数量以及优良率(TAM等级优+良占总比)差异上无统计学意义(P>0.05)。结论 掌长肌腱移植与示指固有伸肌腱转位是治疗自发性拇长伸肌腱断裂的两种有效术式,临床治疗效果满意,疗效上无明显差异。     

桡骨远端骨折后拇长伸肌腱自发性断裂1例

拇长伸肌腱起自桡、尺骨背面和骨间膜,向下止于拇指末节指骨底,其功能为伸拇指,受桡神经支配.拇长伸肌腱走行经过桡骨远端背侧的Lister结节,该区域附近的解剖出现异常,如桡骨远端发生骨折导致骨面不平,使得肌腱在该区域滑动时有磨损,长此以往最终发生断裂,导致拇指无法伸直,严重影响手部功能.肌腱断裂被发现时断端已经回缩,因此...     

Extensor pollicis brevis tendon can hyperextend thumb interphalangeal joint in absence of extensor pollicis longus:Case report and review of the literature

We are reporting a case of extensor pollicis longus tendon rupture which did not require tendon transfer owing to the ability of the intact extensor pollicis brevis(EPB) to fully hyperextend the thumb interphalangeal joint. The thumb metacarpophalangeal joint was also able to be fully actively extended by the EPB. Previous anatomical studies have demonstrated that the insertional anatomy of the EPB tendon is highly variable and sometimes inserts onto the extensor hood and distal phalanx, which is likely the mechanism by which our patient was able to fully extend the thumb interphalangeal joint. Despite the potential for the EPB to extend the IP joint of the thumb, virtually all previously reported cases of extensor pollicis longus(EPL) tendon rupture had deficits of thumb IP extension requiring tendon transfer. This case highlights the potential ability of the EPB tendon to completely substitute for the function of the EPL tendon in providing thumb IP joint extension.     

Concomitant Rupture of Extensor Pollicis Longus and Index Extensor Tendons following Distal Radius Plating—Report of Two Cases and Their Clinical Implication for Tendon Transfer Surgery

Extensor indicis proprius (EIP) tendon transfer is a standard operation for restoration of the thumb extension following rupture of extensor pollicis longus (EPL). In its standard form often the EIP is transferred to the EPL without inspection of the extensor tendons in the fourth compartment and it is retained in its anatomical fourth compartment. However, in a setting of EPL rupture in relation to the distal radius fracture (with or without fixation), concomitant injury to the extensor tendons to the index finger may result in failure of the transfer and even a loss of index finger extension (index finger drop) further complicating the reconstruction and resulting in immense patient dissatisfaction. We herein present two such rare cases to highlight this clinical scenario and how an awareness of this possibility and inspection of the extensor tendons to the index finger before EIP transfer allowed us to prevent this complication. In essence, if we know it, we can prevent it.     

Delayed Rupture of Flexor Pollicis Longus after Volar Plating for a Distal Radius Fracture

Although extensor tendon rupture often occurs after volar plating for a distal radius fracture, a flexor tendon rupture is extremely rare. Most reported instances of flexor tendon ruptures after volar plating have involved improper placement of the plate, increased prominence of the distal edge of the plate because of collapse of the fracture site, use of custom-made plates, current steroid use by the patient, or a history of tendon injury. We report a case of delayed rupture of the flexor pollicis longus tendon 40 months after volar plating with a 3.5-mm T-locking compression plate for which the distal edge was located at the transverse ridge level of the distal radius. If symptoms such as tendon irritation occur in this situation, surgeons should consider removing the plate as soon as possible after bony union is achieved.     

Extensor pollicis longus dysfunction associated with non-united fracture of the trapezium

A 26 year old man was referred to us with extensor pollicis longus dysfunction (EPL), and investigation revealed a fracture of the trapezium (left) and carpo-metacarpal joint dislocation of the thumb. Operative exploration revealed mechanical displacement of the tendon secondary to fracture dislocation of the trapezium as the cause for EPL dysfunction. The lesion was managed with an open reduction and screw fixation resulting in good functional outcome.