小腿中段离断再植后重建足跖屈背伸功能

目的 探讨小腿中段离断再植后足跖屈背伸功能重建的方法。方法 常规断肢再植，术中将离断肢远段失神经支配的肌组织切除，只保留肌腱及肌腱膜，切取髂胫束条桥接远端背伸肌腱和近端肌腹，同时和前移缝匠肌、股二头肌长头缝接，加强足背伸肌力；桥接远端跖屈肌腱和近端肌腹，同时和游离的半腱肌、股薄肌缝接，加强足跖屈肌力。结果 治疗2例，分别随访2年8个月及2年5个月，足背伸、跖屈肌力达Ⅳ－Ⅵ^ ，踝关节活动度近正常。结论 应用髂胫束条桥接远断端的肌腱和近断端的正常肌组织，同时利用缝匠肌、股二头肌、半腱肌、股薄肌加强瞳的背伸、跖屈肌力，是一种有效的功能重建方法。

Reconstruction of foot flexion-extension function after replantation of amputated leg

Objective To investigate the foot function reconstruction after replantation of amputated leg. Methods The nerveless injury muscle in the amputated limbs was cut off, a section tensor fascia lata was resected off to replace the injured muscle. Meanwhile, transfer biceps femoris muscle and sartorius muscle to strengthen extensive muscles, and transfer semimembranosus muscle and gracilis muscle to strengthen flexion muscles. Postoperation functional exercises of the ankle was carried out. Results 2 patients were treated with this technique, followed up for more than 2 years. The extension and flexion muscle strength reached MRC4 with satisfactory ankle function, the range of motion of ankle was restored nearly to normal. Conclusion The technique is effective to reconstruct most functions of the normal muscles and restore foot function.