尺侧腕伸肌联合拇短伸肌腱转移重建拇指对掌功能

目的评价尺侧腕伸肌联合拇短伸肌腱转移重建拇指对掌功能的临床疗效。方法 2006年3月-2009年8月,采用尺侧腕伸肌联合拇短伸肌腱转移重建20例单纯腕部正中神经损伤、15例正中神经合并尺神经损伤患者的拇指对掌功能。其中男25例,女10例;年龄20～53岁,平均33.5岁。致伤原因:锐器伤24例,钝器伤9例,热压伤2例。合并尺、桡骨远端骨折6例。患者均于伤后1～3 h行神经修复术,平均2 h。受伤至该次入院时间为6～14个月,平均7.5个月。35例患者除2例单纯正中神经损伤拇外展功能不完全消失、无对掌功能外,其余拇外展及主动对掌功能完全消失。结果术后切口均Ⅰ期愈合。患者均获随访,随访时间12～18个月,平均14个月。腕关节屈伸、拇指末节背伸活动正常。20例单纯正中神经损伤患者均恢复正常拇外展及对掌功能。15例合并尺神经损伤患者中,13例恢复正常对掌功能,2例对掌功能不全;拇外展功能均恢复良好。术后12个月,根据赵书强等拇指对掌功能评定标准,患者拇对掌功能测量值均在正常范围。结论对单纯正中神经损伤或合并尺神经损伤患者,尺侧腕伸肌联合拇短伸肌腱转移是一种操作简便且有效的手术方法。

RECONSTRUCTION OF THUMB OPPOSITION FUNCTION BY TRANSFERRING EXTENSOR CARPI ULNARIS AND EXTENSOR POLLICIS BREVIS MUSCLE TENDONS

Objective To evaluate the results of thumb opposition function by transferring the extensor carpi ulnaris and the extensor pollicis brevis muscle tendons.Methods Between March 2006 and August 2009,35 patients with dysfunction of thumb opposition were treated and the thumb opposition function was reconstruced by transferring the extensor carpi ulnaris and the extensor pollicis brevis muscle tendons.There were 25 males and 10 females with an average age of 33.5 years(range,20-53 years);20 had median nerve inj...