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高低位桡神经麻痹中各种肌腱转位结果的评估。

Evaluation of results of various tendon transfers in high and low radial nerve palsy.

作者信息

Kumar Vyas Amit, Gupta Aviral, Patni Purnima, Saini Narender, Lad Parag B

机构信息

Fortis Escorts Hospital, Jaipur, India.

SMS Medical College, Jaipur, Rajasthan, India.

出版信息

J Clin Orthop Trauma. 2020 Jul-Aug;11(4):614-619. doi: 10.1016/j.jcot.2020.05.023. Epub 2020 Jun 14.

Abstract

BACKGROUND

Various combinations of tendon transfers are available for radial nerve palsy. However, the choice of which set of transfer to be performed in a patient remains an issue of varied opinions among surgeons. The study attempts to evaluate the results of various tendon transfers for radial nerve palsy quantitatively and subjectively. It also identifies which set of transfer is suitable for particular groups of patients.

MATERIALS AND METHODS

The study was conducted between 2005 and 2007. A total of 15 tendon transfers were performed using various combinations and evaluated according to Bincaz's criteria, Kapandji scale and effect of tendon transfers on activities of daily living.

RESULTS

13 patients had excellent to fair outcome according to Bincaz's criteria. 2 patients had poor outcome. There was no hindrance in the activities of daily life in all patients. 93.4% of patients were satisfied with the results.

CONCLUSION

Every combination of tendon transfers has its own set of merits and demerits. Selection of donor tendons as per occupational need of patients is utmost important. Patients in our series were satisfied with set of transfers using Pronator teres(PT) for wrist extension, Flexor carpi radialis (FCR) for finger extension and rerouted Palmaris longus (PL) for extension of thumb. Flexor carpi ulnaris (FCU) is important for power grip.

摘要

背景

对于桡神经麻痹,有多种肌腱转移组合可供选择。然而,在患者中选择进行哪种转移组合在外科医生中仍是一个存在不同意见的问题。本研究试图定量和主观地评估各种肌腱转移治疗桡神经麻痹的结果。它还确定哪种转移组合适合特定组别的患者。

材料与方法

本研究于2005年至2007年进行。共进行了15次使用不同组合的肌腱转移,并根据宾卡兹标准、卡潘迪量表以及肌腱转移对日常生活活动的影响进行评估。

结果

根据宾卡兹标准,13例患者预后为优至良。2例患者预后差。所有患者的日常生活活动均无阻碍。93.4%的患者对结果满意。

结论

每种肌腱转移组合都有其自身的优缺点。根据患者的职业需求选择供体肌腱至关重要。在我们的系列研究中,患者对使用旋前圆肌(PT)进行腕关节伸展、桡侧腕屈肌(FCR)进行手指伸展以及重新路由的掌长肌(PL)进行拇指伸展的转移组合感到满意。尺侧腕屈肌(FCU)对强力抓握很重要。

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