Schaller Peter, Baer Wolfgang, Carl Hans-Dieter
Department of Hand Surgery and Plastic Surgery, Kliniken Dr. Erler gGmbH, Nuremberg, Germany.
Scand J Plast Reconstr Surg Hand Surg. 2007;41(1):33-5. doi: 10.1080/02844310601070351.
Either an extensor indicis transposition (EIT) or an intercalated free tendon graft (FTG) can be used for secondary reconstruction of the extensor pollicis longus (EPL) tendon. We reviewed 1469 cases of extensor tendons repaired between 1992 and 2003 and compared the results. In only 55 patients was an isolated secondary reconstruction of the EPL done. Forty-five patients (82%) were available for clinical follow-up after a mean of 4.3 (range 2-11) years (28 (62%) who had EIT and 17 (38%) who had FTG). Thumb function was assessed postoperatively using Geldmacher's criteria, and the uninjured thumb served as control. The comparison showed no significant differences between the procedures for the single variables evaluated, or for the injured and other (uninjured) thumb in either group. For isolated secondary reconstruction of the EPL tendon, both the extensor indicis transposition and a free autologous tendon graft successfully restore thumb function. Therefore, both surgical techniques can be considered equal alternatives.
示指伸肌转位术（EIT）或嵌入游离肌腱移植术（FTG）均可用于拇长伸肌（EPL）肌腱的二期重建。我们回顾了1992年至2003年间修复的1469例伸肌腱病例并比较了结果。仅55例患者进行了孤立的EPL二期重建。45例患者（82%）在平均4.3年（范围2 - 11年）后可进行临床随访（28例（62%）接受EIT，17例（38%）接受FTG）。术后使用盖尔德马赫标准评估拇指功能，未受伤的拇指作为对照。比较结果显示，对于所评估的单一变量，或两组中受伤拇指与另一只（未受伤）拇指之间，两种手术方法均无显著差异。对于孤立的EPL肌腱二期重建，示指伸肌转位术和自体游离肌腱移植术均能成功恢复拇指功能。因此，这两种手术技术均可视为等效的选择。
