Hastings H, Davidson S
Indiana University School of Medicine, Indianapolis.
Hand Clin. 1988 May;4(2):167-78.
Tendon transfers for correction of clawing deformity in ulnar nerve palsy are only consistently successful in young ligamentously lax individuals. Correction of deformity is most inconsistent in the intrinsically stiff hands of older individuals. Correction of clawing is more difficult in the little finger than in the ring finger. While use of the flexor digitorum superficialis for intrinsic transfer simply corrects clawing deformity and restores synchronous finger flexion, grip strength will be further decreased by approximately 21 percent, and total active range of motion by 7 percent. Correction is best achieved by transfer of a wrist motor with tendon graft into index, middle, ring, and little digits, despite limitation of clawing to the ring and little digits. Pinch should be augmented by metacarpophalangeal joint fusion rather than by interphalangeal joint fusion. When combined with extensor carpi radialis brevis adductor plasty, pinch strength can be doubled.
用于矫正尺神经麻痹所致爪形畸形的肌腱转移术仅在年轻、韧带松弛的个体中持续取得成功。在年长者手部固有僵硬的情况下，畸形矫正的效果最不稳定。小指爪形畸形的矫正比环指更困难。虽然使用指浅屈肌进行固有肌转移仅能矫正爪形畸形并恢复手指同步屈曲，但握力将进一步降低约21%，总主动活动范围降低7%。尽管爪形畸形仅局限于环指和小指，但通过将带肌腱移植的腕部肌肉转移至示指、中指、环指和小指，可实现最佳矫正效果。应通过掌指关节融合而非指间关节融合来增强捏力。当与桡侧腕短伸肌内收肌成形术联合使用时，捏力可加倍。
