Kawamura Kenji, Yajima Hiroshi, Tomita Yasuharu, Kobata Yasunori, Shigematsu Koji, Takakura Yoshinori
Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan.
J Shoulder Elbow Surg. 2007 Jan-Feb;16(1):84-90. doi: 10.1016/j.jse.2006.03.006.
Restoration of elbow function is a challenge for orthopaedic surgeons, and many procedures have been described. This study reviewed 17 patients who underwent latissimus dorsi myocutaneous flap transfer for functional reconstruction of elbow flexion or extension. Of the 10 patients who underwent reconstruction for elbow flexion, grade 4 strength of elbow flexion by manual muscle testing was obtained in 8 and grade 3 was obtained in 2. Mean postoperative active elbow flexion was 111 degrees . Of the 7 patients who underwent reconstruction for elbow extension, grade 4 strength of elbow extension was obtained in 3, grade 3 was obtained in 3, and grade 2 was obtained in 1. The 3 patients showing unsatisfactory restoration of flexion or extension strength had associated preoperative weakness of the latissimus dorsi muscle. Preoperative assessment of the latissimus dorsi muscle was most important for obtaining satisfactory results, because preoperative muscle strength influenced the postoperative functional outcome.
恢复肘关节功能对骨科医生来说是一项挑战，并且已经描述了许多手术方法。本研究回顾了17例行背阔肌肌皮瓣转移术以进行肘关节屈伸功能重建的患者。在10例行肘关节屈曲重建的患者中，8例通过徒手肌力测试获得了4级肘关节屈曲力量，2例获得了3级。术后平均主动肘关节屈曲度为111度。在7例行肘关节伸展重建的患者中，3例获得了4级肘关节伸展力量，3例获得了3级，1例获得了2级。3例屈伸力量恢复不理想的患者术前背阔肌存在相关无力情况。术前评估背阔肌对于获得满意结果最为重要，因为术前肌肉力量会影响术后功能结局。
