Matter-Parrat V, Prunières G, Collon S, Facca S, Liverneaux P, Hidalgo Diaz J J
Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
Department of Orthopedics, SOS main, Caen University Hospital, avenue de la Côte-de-Nacre, 14000 Caen, France.
Hand Surg Rehabil. 2017 Feb;36(1):36-40. doi: 10.1016/j.hansur.2016.09.013. Epub 2016 Oct 28.
Complications following extensor indicis proprius (EIP) tendon transfer are loss of strength, independence and mobility in the index finger in extension. The main goal of this study was to measure the index finger's independent and dependent extension strength after a tendon transfer. Secondary goals were to determine if the index finger retained the ability to extend independently after the transfer and to evaluate second metacarpophalangeal (MCP) joint mobility. Our study consisted of 19 patients in whom the EIP tendon had been divided proximally to the extensor hood. The EIP tendon was retrieved through a proximal approach at the distal radius level and rerouted towards a recipient tendon. At an average follow-up of 41 months, the average independent extension strength was 5.6N versus 11N on the contralateral side and the dependent strength was 10.9N versus 20N. No patient complained of a loss of extension strength and all had retained independent active extension on the operated index finger. The second MCP joint on the operated side had an independent extension lag of 15.3° compared to the contralateral healthy side and a dependent extension lag of 0.2°. Two patients were impaired in their daily activities when moving the operated index finger. Our results show that EIP harvesting for tendon transfer leads to decreased independent and dependent strength as well as decreased active extension of the second MCP joint. However, the functional impact was negligible and should not compromise the use of the EIP as a tendon transfer.
III.
示指固有伸肌（EIP）肌腱转移术后的并发症是示指伸展时力量、独立性和活动度丧失。本研究的主要目的是测量肌腱转移术后示指的独立和依赖伸展力量。次要目的是确定转移术后示指是否仍保留独立伸展能力，并评估第二掌指（MCP）关节的活动度。我们的研究包括19例患者，其EIP肌腱在伸肌帽近端被切断。通过桡骨远端水平的近端入路取出EIP肌腱，并重新路由至受区肌腱。平均随访41个月时，平均独立伸展力量为5.6N，对侧为11N，依赖力量为10.9N，对侧为20N。没有患者抱怨伸展力量丧失，所有患者手术侧示指均保留独立主动伸展。与对侧健康侧相比，手术侧第二MCP关节独立伸展滞后15.3°，依赖伸展滞后0.2°。两名患者在移动手术侧示指时日常活动受到影响。我们的结果表明，用于肌腱转移的EIP取材会导致独立和依赖力量下降，以及第二MCP关节主动伸展减少。然而，功能影响可忽略不计，不应影响将EIP用作肌腱转移。
III级。
