桡侧腕屈肌腱瓣转位修复下桡尺关节脱位的应用解剖和临床研究  

Anatomy and Clinical Study of the Flexor Carpi Radialis Tendon Transposition Flap to Repair Dislocation of the Distal Radioulnar Joint

作　　者：张传开[1] 宋一平[1] 张发惠[2] 童迅[1] 韩冰[1] 

机构地区：[1]解放军第97医院骨科,江苏徐州221004 [2]南京军区福州总医院临床解剖研究中心

出　　处：《解剖与临床》2012年第5期370-372,共3页Anatomy and Clinics

摘　　要：目的：从解剖学角度研究桡侧腕屈肌腱瓣转位修复下桡尺关节脱位的机理。方法：对30侧成人上肢标本的桡侧腕屈肌腱分段进行形态学测量，并进行力学测试。为36例下桡尺关节脱位患者，设计以桡侧腕屈肌腱部分腱瓣转位修复下桡尺关节。结果：桡侧腕屈肌腱性部分长（14．3±1．1）cm，肌腱的上、中、下段宽分别为（9．1±1．4）mm、（5．5±0．9）mm和（4．0±0．4）mm，肌腱的上、中、下段厚分别为（2．4±0．6）mm、（2．2±0．4）mm和（2．6±0．5）mm。36例患者术后随访5—10a，平均6．5a。其中优23例，腕关节酸痛基本消失，旋转70°-120°，X线片示正常；良12例，腕关节轻度酸痛，旋转度数改善，X线片示正常；差1例，腕关节仍有酸痛，旋转度数无明显改善，X线片示正常。优良率97．2％。结论：桡侧腕屈肌腱部分转位有足够的长度和强度以修复下桡尺关节脱位，临床应用效果良好。To confirm the mechanism of flexor carpi radialis tendon transposition flap to repair dislocation of the distal radioulnar joint from the anatomical point. Methods： 30 adult upper limb specimens carpi flexor tendon were measured sectionally in the morphological and proceeded with biomechanical test.Flexor carpi radialis tendon partial tendon flap transposition was designed for the repair of 36 cases with dislocation of distal radioulnar joint. Results：The length of the tlexor carpi radialis tendons was （ 14.3 ± 1. 1 ） cm. The tendon width of upper segment, middle segment, lower segment were （9. 1 ± 1.4） mm, （5.5 ± 0.9） mm and （4.0 ± 0.4 ） ram. The tendon thickness of upper segment, middle segment, lower segment were （ 2.4 ± 0.6） ram, （2.2 ± 0.4 ） mm and （2.6±0.5 ）mm respectively. 36 cases were followed up from 5 to l0 years, with an average of 6.5 years. Among them ,23 cases were cxecllent, wrist pain disappeared, rotated from 70 degrees to 120 degrees, X -ray showed normally; Good in 12cases, miht pain of wrist joint, the degree of rotation to improve, X - ray showed nor- mally; Poor in I ease, the wrist was still sore, the degree of rotation did not improve significantly, X - ray showed normally. The excellent and good rate were 97.2%. Conclusions： Partial transposition of the tendon of flexor carpi radialis has sufficient length and strength to repair dislocation of distal radioulnar joint; the clinical application effect is good.

关 键 词：桡侧腕屈肌腱 下桡尺关节 关节脱位 肌腱转移术 

分 类 号：R322.7[医药卫生—人体解剖和组织胚胎学] R686.1[医药卫生—基础医学] R684.7