拇指对掌功能重建的临床应用

目的 评价尺侧腕伸肌-拇短伸肌腱移位术的临床疗效。方法 通过对20侧新鲜成人尸体上肢标本的应用解剖学研究，建立以尺侧腕伸肌为动力肌，拇短伸肌腱移位术的解剖模型，并观察到该肌腱移位后的走行和拇短展肌的走行基本一致，并有旋前功能。2004年2月-2005年1月，对6例拇指对掌功能丧失者，实施肌腱移位术重建拇指对掌功能。结果 术后随访3～12个月，拇指对掌功能满意。6例中优5例，良1例，优良率为100％。结论 尺侧腕伸肌-拇短伸肌腱移位术，手术方式简单，重建拇指对掌功能效果满意。

Anatomical model of opponensplasty and its clinical application

Objective To study the anatomical elements of reconstruction of thumb opposition, and to evaluate the results of opponensplasty by transferring the extensor carpi ulnaris and the extensor pollicis brevis muscle tendon. Methods Anatomical models of tendon transfer for opponensplasty were established by using 20 fresh adult cadever upper extremities. Transfer of the extensor carpi ulnaris (ECU) to the extensor pollicis brevis (EPB) was simulated on cadever spacimens. The courses of the transfer were observed. ECU to EPB opponensplasty was carried out in 6 cases of dysfunction of thumb opposition from Febrary 2004 to January 2005. Results Cadever models of ECU to EPB opponensplasty showed that the direction of the tendon transfer was in accordance to the course of the abductor pollicis brevis. After a period of 3 to 12 months' follow-up, satisfactory thumb opposition was seen. 5 cases were graded as excellent and 1 as good, the overall effective rate being 100%. Conclusion ECU to EPB opponensplasty is a simple and effective procedure for restoring thumb opposition.