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桡侧腕长伸肌肌腱转位在拇指长伸肌重建中的应用:解剖学研究与新手术入路。

Brachioradialis Muscle Tendon Transposition in Extensor Pollicis Longus Reconstruction: Anatomical Study and a New Surgical Approach.

机构信息

Azienda Ospedaliero Universitaria "Ospedali Riuniti," Ancona, Italy.

University of Milan, Italy.

出版信息

Hand (N Y). 2022 Jul;17(4):780-788. doi: 10.1177/1558944720930295. Epub 2020 Sep 16.

Abstract

BACKGROUND

Complete extension of the thumb and activation of the extensor pollicis longus (EPL) tendon are fundamental to ensure maximum function. Many EPL repair techniques are described in the literature.

METHODS

The authors present an alternative technique using the brachioradialis (BR) tendon. Thirty patients with injuries of the EPL tendon in zone 8 were studied. In all cases, neither direct suture repair nor traditional tendon transfer was possible.

RESULTS

Thumb extension was restored in all patients with satisfactory extension recovery. All patients achieved excellent extension; good functional results were observed in 2 cases, and in 1 case satisfactory results were achieved using the Geldmacher assessment and the Kapandji assessment. The overall results were rated as excellent, good, fair, or poor according to the Quick Disabilities of the Arm, Shoulder, and Hand Scale.

DISCUSSION

The BR tendon was suitable to treat all cases, in particular injuries occurring near Lister's tubercle, due to its appropriate length for tenorrhaphy albeit with a short distal head.

摘要

背景

拇指完全伸展和伸拇长肌(EPL)肌腱的激活对于确保最大功能至关重要。文献中描述了许多 EPL 修复技术。

方法

作者介绍了一种使用肱桡肌(BR)肌腱的替代技术。研究了 30 名 EPL 肌腱在 8 区受伤的患者。在所有情况下,直接缝合修复或传统肌腱转移均不可行。

结果

所有患者的拇指伸展均得到恢复,且伸展恢复情况令人满意。所有患者均获得了极好的伸展效果;2 例患者的功能结果良好,1 例患者使用 Geldmacher 评估和 Kapandji 评估获得了满意的结果。根据 Quick Disabilities of the Arm, Shoulder, and Hand Scale,整体结果评定为优、良、可和差。

讨论

BR 肌腱适合治疗所有病例,特别是在 Lister 结节附近发生的损伤,因为其肌腱长度适合进行肌腱缝合,尽管其远端头部较短。

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