Medina José, Marcos-García Alberto, Jiménez Isidro, Muratore Gustavo, Méndez-Suárez José Luis
Unit of Hand, Upper Limb and Peripheral Nerve, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain.
Unit of Spinal Cord Injury, Department of Rehabilitation, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain.
Hand (N Y). 2017 Jan;12(1):85-90. doi: 10.1177/1558944716646764. Epub 2016 Apr 29.
Management and indications for surgery in the tetraplegic patient are highly complex because of the substantial functional deficits that they present and their effect on their daily activity. Our purpose was to evaluate the functional outcome in tetraplegic patients who underwent biceps-to-triceps transfer surgery according to Zancolli's modified technique. This is a retrospective study of 6 biceps-to-triceps transfers using Zancolli's modified technique in 4 patients. Mean follow-up was 45 months. We evaluated each patient's DASH (Disabilities of the Arm, Shoulder and Hand) score before surgery and 12 months later. In the 6 arms that underwent surgery, full and active elbow extension against gravity at 12 months after surgery was achieved. The mean DASH score was 73.2 preoperatively and 20.8 twelve months postoperatively. One complication occurred. One patient reported loss of elbow flexion preventing thigh lift for transfers. This was resolved with a program of rehabilitation and specific muscle strengthening Zancolli's modified technique is simple and effective, with few complications, whereby we can provide more autonomy for the tetraplegic patient.
由于四肢瘫痪患者存在严重的功能缺陷及其对日常活动的影响，其手术管理和手术指征极为复杂。我们的目的是评估根据赞科利改良技术接受肱二头肌至肱三头肌转移手术的四肢瘫痪患者的功能结局。这是一项对4例患者采用赞科利改良技术进行6次肱二头肌至肱三头肌转移手术的回顾性研究。平均随访时间为45个月。我们评估了每位患者术前及术后12个月的上肢、肩部和手部功能障碍（DASH）评分。在接受手术的6只手臂中，术后12个月实现了在重力作用下完全主动的肘部伸展。术前平均DASH评分为73.2，术后12个月为20.8。发生了1例并发症。1例患者报告肘部屈曲丧失，妨碍了转移时抬腿。通过康复计划和特定的肌肉强化训练，这一问题得到了解决。赞科利改良技术简单有效，并发症少，由此我们可以为四肢瘫痪患者提供更多自主性。
