Seal Alexander, Stevanovic Milan
Plastic and Reconstructive Surgery, University of British Columbia, Vancouver, BC, Canada.
Hand and Microsurgery, Keck School of Medicine, University of Southern California, Los Angeles, Calif.
Plast Reconstr Surg Glob Open. 2018 May 10;6(5):e1736. doi: 10.1097/GOX.0000000000001736. eCollection 2018 May.
Traumatic injuries and other conditions resulting in thenar loss and loss of opposition function can cause significant functional limitations. There are limited options available to restore function and bulk to the thenar musculature. A 26-year-old man had an unfortunate accident at work with a machine mixer creating a crush injury to his left hand. This required several debridements due to the tissue injury and resulted in loss of the thenar muscles and ability to oppose the thumb. He recovered well from the initial injury, however, was left with difficulty with grasp and holding objects due to the loss of thenar motion and strength. His function was also affected by the loss of bulk. He successfully underwent a free functional muscle reconstruction with his serratus anterior. This case report is a description of his reconstruction and a review of the literature. The patient had an excellent outcome. He obtained active opposition and improved grip strength, improving his activities of daily living and vocational life. The serratus anterior muscle can successfully be used for thumb opposition reconstruction. This case report demonstrates good outcomes for both motion and bulk restoration.
创伤性损伤和其他导致大鱼际肌丧失及对掌功能丧失的情况会造成显著的功能限制。恢复大鱼际肌功能和体积的选择有限。一名26岁男性在工作时遭遇不幸事故，被机器搅拌机挤压左手，因组织损伤进行了多次清创，导致大鱼际肌丧失及拇指对掌功能丧失。他从最初的损伤中恢复良好，但由于大鱼际肌运动和力量丧失，抓握和握持物体困难。其功能还因肌肉体积丧失而受影响。他成功接受了游离功能性肌肉重建术，使用的是前锯肌。本病例报告描述了他的重建过程并对文献进行了综述。患者预后良好。他获得了主动对掌功能并提高了握力，改善了日常生活和职业生活。前锯肌可成功用于拇指对掌重建。本病例报告展示了在运动和体积恢复方面的良好效果。
