Keenan M A, Korchek J I, Botte M J, Smith C W, Garland D E
Adult Head Trauma Service, Ranchos Los Amigos Medical Center, Downey, California 90242.
J Bone Joint Surg Am. 1987 Oct;69(8):1127-32.
Thirty-one patients who had transfer of the flexor digitorum superficialis tendons to the flexor digitorum profundus tendons en masse in thirty-four non-functional spastic hands were examined at an average of fifty months postoperatively. All of the patients had had a clenched-fist deformity preoperatively, with severe hygienic problems of the palmar skin and no active function of the hand. Postoperatively, all of the hands were in an open position, which allowed for good hygiene of the palmar surface. A minor wound infection developed in three patients. Neurectomy of the motor branch of the ulnar nerve distal to the Guyon canal was needed for control of spasticity of the intrinsic muscles in twenty-five hands. An intrinsic-minus deformity did not develop in any of the hands that had neurectomy of the ulnar nerve, although an intrinsic-plus deformity developed in seven of the nine hands that did not have a neurectomy.
对34只无功能的痉挛性手部进行了指浅屈肌腱整体转移至指深屈肌腱手术的31例患者,在术后平均50个月时接受了检查。所有患者术前均有握拳畸形,手掌皮肤存在严重卫生问题,手部无主动功能。术后,所有手部均处于张开位,这有利于手掌面保持良好卫生。3例患者发生了轻微伤口感染。25只手需要对Guyon管远端的尺神经运动支进行神经切除术,以控制内在肌的痉挛。接受尺神经切除术的手部均未出现内在肌减力畸形,而未进行神经切除术的9只手中有7只出现了内在肌过强畸形。