Lee Jae Hoon, Cho Young Joo, Chung Duke Whan
From the Department of Orthopedic Surgery, School of Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul, Korea.
Ann Plast Surg. 2015 Dec;75(6):607-9. doi: 10.1097/SAP.0000000000000593.
This study evaluated the outcomes of extensor indicis proprius (EIP) transfer based on varying degrees of thumb extension after EIP transfer and elongation of the EIP. A total of 24 cases with extensor pollicis longus (EPL) ruptures who underwent EIP to EPL transfer were analyzed prospectively. The EIP transfer was performed with neutral wrist positioning. In group I (12 cases), EIP and EPL were sutured on the thumb in neutral state at interphalangeal joint, and the mean EIP elongation of this group measured 0.2 cm (range, -0.5 to 0.5 cm). In group II (12 cases), EIP and EPL were sutured on the thumb in full extension state at interphalangeal joint, and the mean EIP elongation measured 0.7 cm (range, 0.5-1.5 cm). The mean follow-up period was 13.5 months. The 2 groups were compared based on thumb motion, grip strength, pinch power, and the Disabilities of the Arm, Shoulder, and Hand questionnaire score. Extension of the thumb at the interphalangeal joint was -5.2° in group I and 7.2° in group II, demonstrating statistically significant differences. No significant differences were found between the 2 groups in other parameters. In EIP transfer, thumb in extension after transfer and EIP elongation is recommended for restoring thumb extension at the interphalangeal joint.
本研究基于示指固有伸肌（EIP）移位及EIP延长后不同程度的拇指伸展情况，评估了EIP移位的效果。对24例行EIP移位至拇长伸肌（EPL）修复EPL断裂的病例进行了前瞻性分析。EIP移位在腕关节中立位进行。I组（12例），EIP和EPL在拇指指间关节处于中立位时缝合，该组EIP平均延长0.2 cm（范围为-0.5至0.5 cm）。II组（12例），EIP和EPL在拇指指间关节处于完全伸展位时缝合，EIP平均延长0.7 cm（范围为0.5至1.5 cm）。平均随访期为13.5个月。根据拇指活动度、握力、捏力以及上肢、肩部和手部功能障碍问卷评分对两组进行比较。I组拇指指间关节伸展度为-5.2°，II组为7.2°，差异有统计学意义。两组在其他参数方面未发现显著差异。在EIP移位时，建议移位后拇指处于伸展位并延长EIP，以恢复拇指指间关节的伸展。
