Treanor W J, Moberg E, Buncke H J
North Coast Rehabilitation Center, Santa Rosa, California.
Paraplegia. 1992 Jul;30(7):457-66. doi: 10.1038/sc.1992.99.
In a series of 65 tetraplegic hands with severe disabling spasticity and/or flexion contracture, selective flexor tendon elongation procedures were employed to improve their static and kinetic postures. A kinetic approach was adopted, utilizing local anesthesia in a wide-awake patient. This was employed to allow for the patient's cooperation in determining at surgery the desired length of digital extension at the time of wrist tenodesis action. Elongation of the extensor digitorum communis (EDC), extensor indicis proprius (EIP), and extensor digiti quinti (ED V) were added to correct an 'extrinsic-plus' posture observed in 16 patients following flexor tendon lengthening. With the resultant improvement in the static posture of the digits, tendon transfers could then be employed to provide a more functional tenodesis action. These measures provided both improved palmar contact and prehension.
在一系列65例患有严重致残性痉挛和/或屈曲挛缩的四肢瘫患者的手部治疗中，采用了选择性屈肌腱延长手术来改善其静态和动态姿势。采用了一种动态方法，在清醒的患者中使用局部麻醉。这样做是为了让患者在手术中配合确定腕关节固定动作时手指伸展的理想长度。增加了指总伸肌（EDC）、示指固有伸肌（EIP）和小指伸肌（ED V）的延长，以纠正16例患者在屈肌腱延长后出现的“外在肌过强”姿势。随着手指静态姿势的改善，然后可以采用肌腱转移来提供更具功能性的固定动作。这些措施改善了手掌接触和抓握功能。
