Fridén Jan, Lieber Richard L
Department of Hand Surgery, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden.
Clin Orthop Relat Res. 2002 Oct(403 Suppl):S163-70.
Tendon transfers commonly are used to restore arm and hand function after injury to the main motor nerves or after spinal cord injury. Surgeons traditionally use passive tension to determine the length at which a muscle should be attached during tendon transfer. The principles used to choose the length at which the transferred muscle should be attached still are relatively vague and have not been examined thoroughly. Misunderstanding of the sarcomere length-passive tension relationship can result in severe overstretch of the muscle and poor function. Upper extremity muscles have operating ranges that vary between synergists and antagonists, and recent architectural and biochemical data suggest that upper extremity muscles are designed to provide optimal control of joint position and stability. It is hypothesized that a significant functional improvement will be realized when muscles are reattached during tendon transfer procedures at the appropriate length and tension.
肌腱转移术通常用于在主要运动神经损伤后或脊髓损伤后恢复手臂和手部功能。传统上，外科医生在肌腱转移术中使用被动张力来确定肌肉应附着的长度。用于选择转移肌肉应附着长度的原则仍然相对模糊，尚未得到充分研究。对肌节长度与被动张力关系的误解可能导致肌肉严重过度拉伸和功能不佳。上肢肌肉的工作范围在协同肌和拮抗肌之间有所不同，最近的结构和生化数据表明，上肢肌肉旨在提供对关节位置和稳定性的最佳控制。据推测，在肌腱转移手术中，当肌肉以适当的长度和张力重新附着时，将实现显著的功能改善。
