陈旧性高位桡神经损伤后对伸拇功能重建的解剖力学研究  

Natomic Study on the Reconstruction of the Thumb Function after the Old High Sacral Nerve Injury

作　　者：金铄 胡博 刘盛源 赵有鹏 梁策 邢越 李爽 朱春雷[1] Jin Shuo;Hu Bo;Liu Shengyuan;Zhao Youpeng;Liang Ce;Xing Yue;Li Shuang;Zhu Chunlei(Affiliated Hospital Of Beihua University Hand and Foot Microsurgery,Jilin, Jilin, 132011, China)

机构地区：[1]北华大学附属医院手足显微外科,吉林吉林132011

出　　处：《当代医学》2019年第14期56-58,共3页Contemporary Medicine

基　　金：吉林省教育厅(JJKH20170055K);吉林省卫生厅(2017J080)

摘　　要：目的从解剖力学分析应用掌长肌腱经骨间膜窗移位的改良津下法与传统津下法重建伸拇功能的科学性与实用性。方法对40例完整成人上肢标本,测量拇长伸肌和掌长肌肌腹及肌腱长度,然后一组建立应用传统津下法重建伸拇功能的解剖模型(n=20),另一组建立应用掌长肌腱经骨间膜窗移位至拇长伸肌腱的改良津下法重建伸拇功能的解剖模型(n=20),进行伸拇时转位掌长肌腱力量、移位距离及手术时间的测量,对数据进行统计分析。结果①传统津下法:转位的掌长肌伸拇时力量(6.58±0.31),肌腱位移(7.46±0.73)mm,手术所需时间为(50.15±2.72)min;②改良津下法:转位的掌长肌伸拇时力量(5.36±0.21),肌腱位移(5.06±0.42)mm,手术所需时间为(34.56±1.98)min,差异有统计学意义(P<0.05)。改良津下法较传统津下法伸拇需力更少,肌腱位移距离更短,手术操作时间更短。结论改良津下法在处理陈旧性高位桡神经损伤后引起的伸拇功能障碍时较传统津下法更简单,在力学力线上更为科学,可作为陈旧性高位桡神经损伤后重建伸拇功能的方法。Objective To analyze the scientificity and practicability of extensor function of metacarpal tendons through the modified Tsuge method and the traditional Tsuge method. Methods The abdomen and tendon lengths of extensor hallucis longus and palmaris longus muscles were measured in 40 adult upper limb specimens. Then an anatomical model of extensor hallucis function was established by traditional Tsuge method(n=20)in one group, and an improved Tsuge method of reconstructing extensor hallucis function by transferring palmaris longus tendon to extensor hallucis longus tendon through interosseous window in the other group(n=20). The strength, displacement distance and operation time of transposition palmar longus tendon were measured during thumb extension. The data were analyzed statistically. Results(1)Traditional Tsuge method: the strength of the transposed palmar longus muscle was(6.58±0.31), the tendon displacement was(7.46±0.73) mm, and the operation time was(50.15±2.72) min.(2)Improved Tsuge method: the strength of the transposed palmar longus muscle was(5.36±0.21), the tendon displacement was(5.06±0.42) mm, and the operation time was(34.56±1.98) min. The difference was statistically significant(P<0.05). We believe that the improved Tsuge method requires less force, shorter tendon displacement distance and shorter operation time than the traditional Jinxia method. Conclusion The improved Tsuge method is simpler and more scientific than the traditional Tsuge method in treating the thumb extension dysfunction caused by the old high radial nerve injury. It can be used as a method to reconstruct the thumb extension function after the old high radial nerve injury.

关 键 词：桡神经 伸拇功能 腱转移术 

分 类 号：R658[医药卫生—外科学] R322[医药卫生—临床医学]