Mitsionis G, Bastidas J A, Grewal R, Pfaeffle H J, Fischer K J, Tomaino M M
Musculoskeletal Research Center, Department of Orthopaedic Surgery, University of Pittsburgh, PA 15213, USA.
J Hand Surg Am. 1999 Mar;24(2):310-4. doi: 10.1053/jhsu.1999.0310.
We investigated the effect of partial excision of the A2 and A4 digital pulleys, separately and in combination, on finger angular rotation and the energy for finger flexion. Statistically significant decreases in angular rotation resulted only after 50% and 75% excision of A2, A4, or A2 and A4 in combination. Work of flexion trends were weak and none of the changes were statistically significant. Although optimal finger function relies on the integrity of the A2 and A4 pulleys to maintain the efficiency of the digital flexor system, these data suggest that the A2 and A4 pulleys can be excised up to 25%, either separately or in combination, without significant effects on angular rotation. Decreases in total angular range of motion after 50% and 75% pulley excision were small, even for combined pulley excision (9 degrees +/- 3 degrees and 15 degrees +/- 5 degrees [mean +/- SD], respectively), and may be clinically acceptable.
我们分别及联合研究了A2和A4指腱鞘部分切除对手指角旋转及手指屈曲能量的影响。仅在单独切除A2的50%和75%、A4的50%和75%或联合切除A2和A4后，角旋转才出现统计学显著下降。屈曲功趋势较弱，且所有变化均无统计学显著性。尽管最佳手指功能依赖于A2和A4腱鞘的完整性以维持指屈肌系统的效率，但这些数据表明，A2和A4腱鞘可分别或联合切除达25%，而对角旋转无显著影响。即使是联合腱鞘切除，在切除50%和75%腱鞘后，总运动角范围的减小也较小（分别为9度±3度和15度±5度[平均值±标准差]），且在临床上可能是可接受的。
