拇对掌功能重建的新方法  

A new procedure for restoration of thumb opposition

作　　者：成效敏[1] 董震[1] 顾玉东[1] 

机构地区：[1]复旦大学华山医院手外科,上海200040

出　　处：《中华手外科杂志》2003年第4期216-218,共3页Chinese Journal of Hand Surgery

摘　　要：目的 介绍一种简单、有效的拇对掌功能重建新方法。方法 对8例拇对掌功能丧失的患者,采用尺侧腕伸肌为动力肌,拇长伸肌腱改道后(沿拇短展肌方向作一皮下隧道,将拇长伸肌腱沿皮下隧道引至腕上1 cm处掌尺侧直切口内),牵拉改道后之拇长伸肌腱,使拇指呈对掌旋前伸拇位时,将拇长伸肌腱与尺侧腕伸肌腱作编结缝合重建拇对掌功能。结果 术后随访4～11个月,平均8.5个月,8例的拇对掌功能均恢复,达100％的有效率。除1例伸拇功能有轻微影响外,余7例均无明显障碍。结论该术式是一种简单、有效而可靠的重建拇对掌功能的新方法。Objective To introduce a new, simple and efficient procedure for restoration of thumb opposition. Methods Eight cases of patients with loss of opposition were involved in the study. The extensor carpi unlaris was selected for transfer. After a subcutaneous tunnel in line with the fibers of the abductor polhcis brevis was burrowed, the extensor polhcis longus tendon was withdrawn into the incision 1 cm above the wrist at the palmar ulnar side. The rerouted extensor pollicis longus tendon pulled the thumb toward the position of opposition, pronan'on and extension. Then the suture between the extensor pollicis longus tendon and extensor carpi ulnaris tendon was carried out for restoration of thumb oppositon. Results Over a period of 4 to 11 months follow-up (mean 8.5 months) ,the efficient rate was achieved 100% . No marked donor morbidity was observed except that there was slight deficit of thumb extension in 1 case. Conclusion The procedure is a simple, efficient and reliable new strategy for reconstruction of thumb opposition.

关 键 词：拇指 肌张力 拇对掌功能 功能重建 手术方法 

分 类 号：R658[医药卫生—外科学]