食指固有伸肌腱移位重建拇长伸肌功能及评价

目的评价采用食指固有伸肌腱移位重建拇长伸肌功能的临床疗效. 方法对1978年8月～2003年3月以食指固有伸肌移位重建拇长伸肌功能的46例患者进行随访、评价.其中男32例,女14例.年龄16～51岁,平均36岁.外伤陈旧性断裂24例,继发性断裂22例.病程2天～5个月,平均74天. 结果 41例获7个月～23年随访,平均9年3个月.术后拇指抬高丢失0～2.2 cm,平均1.8 cm;拇指屈曲丢失0～3 cm,平均1.6 cm;食指均能单独背伸,背伸丢失0～8度,平均5度.按SEEM评分标准:优29例,良10例,可2例,优良率达95%. 结论食指固有伸肌腱移位重建拇长伸肌功能是一种简便、有效的方法,采用SEEM评价标准使评价结果更加客观和合理.

EVALUATION OF RECONSTRUCTION OF EXTENSOR POLLICIS FUNCTION BY TRANSFER OF EXTENSOR INDICIS

OBJECTIVE: To assess the long-time results of reconstruction of the extensor pollicis longus (EPL) function by transfer of the extensor indicis (EI). METHODS: From August 1978 to March 2003, 46 cases of loss of the EPL function were treated by transfer of the extensor indicis. Of 46 cases, there were 32 males and 14 females, aged 16-51 years with an average of 36 years; there were 24 cases of old traumatic rupture and 22 cases of secondary rupture. The disease course was 2 days to 5 months, averaged 74 days. A specific EI-EPL evaluation method (SEEM) was used to measure the EPL function after transfer. RESULTS: Forty-one cases were followed up 9 years and 3 months on average (7 months to 23 years). Based on the SEEM, the results were excellent and good in 39 of 41 patients. The elevation deficit and combined flexion deficit were 0-2.2 cm (1.8 cm on average) and 0-3 cm (1.6 cm on average); the independent extension deficit was 0 degrees-8 degrees (5 degrees on average). CONCLUSION: Restoration of the extensor pollicis function by transfer of the extensor indicis is an effective and safe treatment option and the SEEM is a valid method for assessing EPL function.