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作 者:杨志明[1] 黄富国[1] 张世琼[1] 项舟[1]
机构地区:[1]华西医科大学附属第一医院骨科
出 处:《中国修复重建外科杂志》1998年第6期336-338,共3页Chinese Journal of Reparative and Reconstructive Surgery
摘 要:臂丛神经损伤或小儿麻痹后遗症,因肌肉麻痹导致旋后功能障碍,影响手功能的发挥。为了寻找重建旋后功能的动力肌,解剖观察了50侧成年男尸的桡侧腕屈肌。发现该肌有多源性血管供血,主要来自肱动脉和桡动脉。由正中神经肌支支配肌肉运动;只要保留近侧1/3肌腹便能保证全肌的血液供应及神经支配。根据解剖资料,设计了用桡侧腕屈肌远侧2/3段,经前臂尺侧到桡背侧,将肌腱于前臂极度旋后位,固定在桡骨茎突近端6cm~10cm的桡骨干上。临床应用4例,经平均3.2年随访,旋后功能恢复良好。认为,在尺侧腕屈肌、旋前圆肌麻痹,或需用来重建其它运动功能时。The dysfunction of supination of forearm following injury of brachial plexus or poliomyelitis always affects the function of hand. To find the dynamic muscle for restoration of the supination, the flexor carpi radialis was investigated on fifty male cadavers. The blood supply of the muscle was polygenic, mainly derived from the humoral and radial arteries. The movement of the muscle was innervated by median nerve. If the proximal 1/3 belly of the muscle was reserved, the blood supply and innervation of the complete muscle was reserved. According to the anatomic data, the operative procedure was designed as following: transfer the distal 2/3 of flexor carpi radialis over the ulnar aspect of the forearm to the dorsal-radial side, the tendon was fixed on the radius shaft 6 to 10cm proximal to the styloid process with forearm in full supination. Four patients were treated and after followed up for 3.2 years average, the supination restored. It was discussed that in case of paralysis of the flexor carpi ulnaris and pronator teres, the optimal choice to restore the supination would be flexor carpi radialis.
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