Nunez Fiesky A, Evans Peter J
Cleveland Clinic Foundation, Cleveland, OH.
Tech Hand Up Extrem Surg. 2018 Sep;22(3):99-103. doi: 10.1097/BTH.0000000000000200.
Restoration of longitudinal stability of the forearm continues to pose a difficult challenge for the hand surgeon, and no technique has demonstrated success above others. Longitudinal stability to the forearm is conferred by 3 structures: the radial head, which acts as a primary stabilizer, the interosseous membrane, more specifically, the central band and, the distal radioulnar ligaments which are part of the triangular fibrocartilage complex. A combination of techniques is described in this article to address chronic longitudinal instability of the forearm: (1) ulnar shortening osteotomy to restore ulnar variance, (2) pronator teres transfer was used to reconstruct the central band of the interosseous membrane, and (3) tightrope augmentation was used to prevent elongation during the healing process.
恢复前臂的纵向稳定性对手外科医生来说仍然是一项艰巨的挑战，而且没有哪种技术比其他技术更具优势。前臂的纵向稳定性由三种结构赋予：桡骨头作为主要稳定器，骨间膜，更具体地说是中央束，以及作为三角纤维软骨复合体一部分的下尺桡韧带。本文介绍了一系列技术组合来解决前臂慢性纵向不稳定问题：（1）尺骨短缩截骨术以恢复尺骨长度差异，（2）旋前圆肌转移用于重建骨间膜的中央束，（3）使用钢丝增强技术防止愈合过程中的延长。
