动力型手内在肌功能重建术18例临床分析

目的 分析动力型手内在肌功能重建手术的临床疗效和影响因素.方法 回顾分析18例动力型手内在肌功能重建手术的临床结果(其中改良Bunnell法14例,Brand法4例).术后按疗效功能评定标准和Brand手功能评定标准,得出术后疗效的优良率.结果 术后随访时间为2～30个月,18例术后疗效总优良率为33%.结论 动力型手内在肌功能重建术的适应证为单纯尺神经损伤者,其他复合性损伤术后疗效较差.同时应注重移位动力肌的选择、止点缝合张力等问题.

Dynamic functional reconstruction of hand intrinsic muscles: clinical analysis of 18 cases

Objective To investigate the clinical effect of dynamic functional reeonstruction of hand intrinsic muscles and analyze the factors that affect the outcomes. Methods Retrospective review of 18 cases of dynamic intrinsic function reconstruction was carried out. There were 14 cases treated by modified Bunnell transfer and 4 cases by Brand transfer. Postoperative results were evaluated using previously published standards and Brand hand function criteria to assess the overall satisfaction rate. Results Postoperative follow up ranged from 2 to 30 months. 33% of the 18 eases obtained good results. Conclusion The indication of dynamic functional reconstruction of hand intrinsic muscles is simple ulnar nerve injury. Results for other complex injuries are generally poor. To ensure favorable results it is also very important to select the proper donor for transfer and adjust the tension of insertion properly.