Cuomo Roberto, Grimaldi Luca, Nisi Giuseppe, Brandi Cesare, D'Aniello Carlo
a Unit of Plastic Surgery , University of Siena, Santa Maria Alle Scotte Hospital , Siena ( SI ), Italy.
J Invest Surg. 2019 Apr;32(3):196-198. doi: 10.1080/08941939.2017.1386739. Epub 2017 Nov 2.
Median and Ulnar nerve palsy is a devastating condition that compromise hand function. A procedure of tendon transfer may be helpful to restore the movements by linking palsy muscles to other muscles able to contract. Scientific discoveries and technological innovations have profoundly changed this kind of surgery; studies on sarcomeres, for example, changed the concept of tensioning. To date we know that muscle strength and its contraction capacity depends on many factors (not only tensioning) such as sarcomeres length, cellular cytoskeleton and extracellular matrix composition: all of these factors interact together and in a ways not still fully understood, determining the complex concept of "movement." Technology made possible the production of smaller and more complex prostheses so to open new frontiers for modulation of the tendon length during grasping. These devices, currently studied on computer models, on cadaver or on animals, behaved great impetus to research but are still not suitable for implantation in humans. Challenges are still numerous: for example obtain more biocompatible implantable device, find new surgical approach, new ways to obtain better results for this kind of patients.
正中神经和尺神经麻痹是一种严重影响手部功能的疾病。肌腱转移手术可能有助于通过将麻痹肌肉与其他能够收缩的肌肉相连来恢复运动。科学发现和技术创新深刻改变了这类手术；例如，对肌节的研究改变了张力的概念。到目前为止，我们知道肌肉力量及其收缩能力取决于许多因素（不仅是张力），如肌节长度、细胞细胞骨架和细胞外基质组成：所有这些因素相互作用，其方式仍未完全理解，决定了“运动”这一复杂概念。技术使得生产更小、更复杂的假体成为可能，从而为抓握过程中肌腱长度的调节开辟了新的前沿。这些目前在计算机模型、尸体或动物上进行研究的装置，为研究带来了巨大动力，但仍不适合植入人体。挑战仍然众多：例如，获得更具生物相容性的可植入装置、找到新的手术方法、为这类患者获得更好治疗效果的新途径。
