中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2015年
5期
443-446
,共4页
尺神经损伤%爪形手%尺侧腕伸肌腱%蚓状肌%功能重建
呎神經損傷%爪形手%呎側腕伸肌腱%蚓狀肌%功能重建
척신경손상%조형수%척측완신기건%인상기%공능중건
Ulnar nerve injury%Claw finger%Extensor carpi ulnaris%Lumbricalis%Function reconstruction
目的 探讨利用尺侧腕伸肌腱转位在蚓状肌功能重建、纠正爪形手畸形中的应用. 方法 2009年10月至2011年9月,对12例尺神经损伤后手内在肌麻痹伴爪形手畸形的患者,利用尺侧腕伸肌腱转位加掌长肌腱分束移植行第2～5指蚓状肌功能重建术.术后采用总主动活动度(Total Active Movement,TAM)系统、握力值和总体手功能DASH量表评分对患手功能做出评价. 结果 本组12例随访12 ～ 24个月,平均15.5个月.按总主动活动度系统评定法:本组术后手指主动屈、伸活动功能优4例,良6例,可2例.12例爪形手畸形均得到了矫正,术后患手平均握力较术前提高41％,差异有统计学意义(P＜0.05).术后总体手功能DASH量表评分平均(20.4±6.8)分,较术前的平均(53.6±11.4)分有明显下降(P＜0.05). 结论 利用尺侧腕伸肌腱进行蚓状肌功能重建且经术后指导功能锻炼,能有效纠正爪形手畸形,恢复伤手的部分主动捏物功能,在显著提高伤手握力的同时改善了总体手功能.尤其对伴正中神经损伤或功能下降的患者取得了良好效果.
目的 探討利用呎側腕伸肌腱轉位在蚓狀肌功能重建、糾正爪形手畸形中的應用. 方法 2009年10月至2011年9月,對12例呎神經損傷後手內在肌痳痺伴爪形手畸形的患者,利用呎側腕伸肌腱轉位加掌長肌腱分束移植行第2～5指蚓狀肌功能重建術.術後採用總主動活動度(Total Active Movement,TAM)繫統、握力值和總體手功能DASH量錶評分對患手功能做齣評價. 結果 本組12例隨訪12 ～ 24箇月,平均15.5箇月.按總主動活動度繫統評定法:本組術後手指主動屈、伸活動功能優4例,良6例,可2例.12例爪形手畸形均得到瞭矯正,術後患手平均握力較術前提高41％,差異有統計學意義(P＜0.05).術後總體手功能DASH量錶評分平均(20.4±6.8)分,較術前的平均(53.6±11.4)分有明顯下降(P＜0.05). 結論 利用呎側腕伸肌腱進行蚓狀肌功能重建且經術後指導功能鍛煉,能有效糾正爪形手畸形,恢複傷手的部分主動捏物功能,在顯著提高傷手握力的同時改善瞭總體手功能.尤其對伴正中神經損傷或功能下降的患者取得瞭良好效果.
목적 탐토이용척측완신기건전위재인상기공능중건、규정조형수기형중적응용. 방법 2009년10월지2011년9월,대12례척신경손상후수내재기마비반조형수기형적환자,이용척측완신기건전위가장장기건분속이식행제2～5지인상기공능중건술.술후채용총주동활동도(Total Active Movement,TAM)계통、악력치화총체수공능DASH량표평분대환수공능주출평개. 결과 본조12례수방12 ～ 24개월,평균15.5개월.안총주동활동도계통평정법:본조술후수지주동굴、신활동공능우4례,량6례,가2례.12례조형수기형균득도료교정,술후환수평균악력교술전제고41％,차이유통계학의의(P＜0.05).술후총체수공능DASH량표평분평균(20.4±6.8)분,교술전적평균(53.6±11.4)분유명현하강(P＜0.05). 결론 이용척측완신기건진행인상기공능중건차경술후지도공능단련,능유효규정조형수기형,회복상수적부분주동날물공능,재현저제고상수악력적동시개선료총체수공능.우기대반정중신경손상혹공능하강적환자취득료량호효과.
Objective To investigate the efficacy of using the extensor carpi ulnaris as the motor tendon in correcting claw hand deformity and improving hand function.Methods A total of 12 patients with ulnar nerve palsy and claw finger deformity were included into this study from October, 2009 to September, 2011.Results All ceses had an average followed-up of 15.5 months, ranging from 12 months to 24 months.According to the Total Active Movement (TAM) score, there were 4 cases receiving excellent results, 6 cases receiving good results and 2 cases receiving fair results.The claw finger deformity was corrected and intrinsic hand function improved significantly.The average increase in grip strength was 41％ at the 12 months post operation, compared with the preoperative data (P ＜ 0.05).The mean DASH score decreased from 53.6 ± 11.4 preoperatively to 20.4 ± 6.8 postoperatively (P ＜ 0.05).Conclusion The technique of using the extensor carpi ulnaris as the motor tendon is effective in correcting claw fingers, increasing the grip strength and improving overall hand function.This surgical procedure is also beneficial for patients accompanied by the median nerve injury.
