尺侧腕屈肌移位重建屈肘功能  

Flexor carpi ulnaris transfer for restoration of elbow flexion

作　　者：田文[1] 赵俊会[1] 田光磊[1] 李庆泰[1] 韦加宁[1] 

机构地区：[1]北京积水潭医院手外科,100035

出　　处：《中华手外科杂志》2005年第5期283-285,共3页Chinese Journal of Hand Surgery

摘　　要：目的分析应用嗖侧效.方法对16例臂丛上中干损伤(单纯上干损伤7例,上、中干损伤9例),应用尺侧腕屈肌移位术重建屈肘功能.其中3例于术后8～12个月因移位肌腱肌张力松弛,而再次行移位肌肌腱紧缩或止点重新固定术.结果术后随访6～24个月,平均12个月.屈肘肌力恢复至4级12例,3级3例,2级1例.肘关节主动屈曲0°～130°,平均95°;主动伸直-30°～0°,平均-15°;9例在完成屈肘动作时前臂处于旋前位.结论尺侧腕屈肌移位重建屈肘功能方法简单、效果满意,但术后仍存在移位肌腱肌张力松弛、前臂旋前位屈肘及肘关节伸直障碍等问题,需有待进一步改进.Objective To analyse the results of flexor carpi ulnaris （FCU） transfer for restoration of elbow flexion. Methods 16 cases of brachial plexus injuries （7 cases of upper trunk injuries and 9 cases of upper and middle trunk injuries） were involved in this series. In order to restore elbow flexion, FCU was transferred. 3 of these cases had a second operation to tighten the transfer or re-attach the insertion due to not enough tension of the tendon transfer 8 to 12 months following the first operation. Results Post-operative follow-up ranged from 6 to 24 months, with an average of 12 months. Flexor muscle strength of the elbow recovered to M4 in 12 patients, M3 in 3 patients, and M2 in 1 patient. Active elbow flexion and active elbow extension were 95° and -15° on average, respectively. Pronation of the forearm was seen in 9 patients when they flexed their elbows. Conclusion FCU transfer for restoration of elbow flexion is a simple procedure that leads to satisfactory clinical results. However, problems such as laxation of the transferred tendon, forced forearm pronation with elbow flexion, and extension lag, still need to be solved.

关 键 词：腱移位术 臂丛 随访研究 尺侧腕屈肌 屈肘功能 肌移位术 尺侧 腕 上干损伤 移位肌腱 

分 类 号：R687.2[医药卫生—骨科学]