赵俊会 韦加宁 李淳 田文 潘勇卫 胡琪 赵俊会 韦加宁 李淳 田文 潘勇卫 胡琪 100035 北京积水潭医院手外科 中华手外科杂志 1998 0 14 4


    关键词：臂丛；肌；骨骼；腱转移术；治疗结果 期刊 zhswkzz 0 论著 fur -->


    

【摘要】 目的 介绍应用指浅屈肌移位治疗臂丛C_5～7 根性撕脱伤患者肘关节屈曲功能障碍的方法。方法 在研究11具成人新鲜上肢标本屈肌腱局部解剖学基础上，对9例不可逆臂丛损伤施行指浅屈肌翻转移位术以重建屈肘功能。结果 指浅屈肌76%的血液供应及69%的神经支配集中于指浅屈肌起点以远12cm的肌腹内。保护好这段肌腹的血供及神经，则肌肉的翻转移位是安全的。临床应用9例，术后平均随访15个月，肌力恢复到4级以上6例，3级2例，2级1例，满意率达89%。屈肌腱移位后对手指原有的屈曲功能无明显影响。结论 在不可修复的臂丛上干损伤，同侧背阔肌、胸大肌及尺侧腕屈肌不具备移位条件时，用指浅屈肌腱翻转重建屈肘功能，为安全可靠、行之有效的方法。

Superficial flexor tendon transfer for reconstruction of elbowflexion ZHAO Junhui, WEI Jianing, LI Chun, et al. Department of HandSurgery, Jishuitan Hospital, Beijing 100035

    【Abstracts】 Objective To introduce a new treatmentprocedure to restore elbow flexion after C_5～7 root avulsion of brachialplexus. Methods 11 fresh adult specimen of the upper extremity wereused to study the regional anatomy of flexor digitorum superficials (FDS). FDS transferwas then performed to reconstruct elbow flexion in nine patients whose elbow flexor powerwere absent after C_5～7 root avulsion of brachial plexus. All patients werefollowed up for an average of 15 months. Results The findings inanatomy revealed that 76 % blood supply and 69 % motor innervation of FDS aredistributed in the region from its insertion at the elbow to 12 cm distal to theinsertion. In clinical application, FDS transfer by turning over the distal part of themuscle is safe in that the blood supply and motor innervation are preserved. The overallsatisfactory rate of the clinical series was 89 %, with muscle strength restored to M₄ in six cases, M₃ in two and M₂ in one. No evident impairment of thefunction of finger flexion was seen after FDS transfer. Conclusions FDStransfer is a safe and effective procedure for reconstruction of elbow flexion in caseother procedures such as pectoralis major transfer, latissimus dorsi transfer and flexorcarpi ulnaris transfer, are not applicable.

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