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孤立性低位正中神经麻痹中对掌肌成形术技术的比较

Comparison of opponensplasty techniques in isolated low median nerve palsy.

作者信息

Yavari Pedram, Fadaei Behrouz, Ghasemi Darestani Nadia, Joni Saeid Sadeghi, Tavakoli Peyman, Mohammadsharifi Ghasem

机构信息

Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran.

Department of Orthopedic Surgery, Kashani Hospital, Isfahan University of Medical Sciences Isfahan, Iran.

出版信息

Int J Burns Trauma. 2020 Oct 15;10(5):263-268. eCollection 2020.

Abstract

BACKGROUND

Thumb opposition is a critical operation of thumb. Median nerve palsy interferes with a large number of ordinary activities such as opposition. Opponensplasty for low median nerve injury is performed with various techniques. The purpose of this study is to compare tendon transfer techniques of Riordan and Burckhalter.

METHODS

This study was a clinical trial performed on 120 patients who underwent Opponensplasty. Patients with traumatic low nerve palsy were divided into two equal groups of Riordan and Burckhalter operation. Demographic information, functional status, Kapandji score, and Pulp pinching method were recorded and compared for all patients 3 months and 8 months after surgery.

FINDINGS

Performance status, Kapandji score and Pulp pinching tests showed significant improvements in both groups after surgeries. The changes in pressure between the thumb and fifth finger were significantly greater in the Burckhalter method compared with Riordan method (P<0.05). The incidence of complications was significantly higher in the Riordan group (P=0.01).

CONCLUSION

According to the present study, there was no differences between Burckhalter and Riordan methods in terms of opposition recovery, although Burckhalter's opponensplasty had better therapeutic results. Postoperative complications were also less in the Burckhalter method.

摘要

背景

拇指对掌是拇指的一项关键动作。正中神经麻痹会干扰诸如对掌等大量日常活动。针对低位正中神经损伤的对掌肌成形术有多种技术。本研究的目的是比较里奥丹(Riordan)和伯克哈特(Burckhalter)的肌腱转移技术。

方法

本研究是一项针对120例行对掌肌成形术患者的临床试验。创伤性低位神经麻痹患者被分为接受里奥丹手术和伯克哈特手术的两组,每组人数相等。记录并比较所有患者术后3个月和8个月的人口统计学信息、功能状态、卡潘迪(Kapandji)评分及捏纸浆法。

结果

两组患者术后的表现状态、卡潘迪评分及捏纸浆测试均有显著改善。与里奥丹方法相比,伯克哈特方法中拇指与小指之间压力的变化显著更大(P<0.05)。里奥丹组的并发症发生率显著更高(P=0.01)。

结论

根据本研究,尽管伯克哈特的对掌肌成形术治疗效果更好,但在对掌恢复方面,伯克哈特方法与里奥丹方法并无差异。伯克哈特方法的术后并发症也更少。

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Modified Camitz opponensplasty for treatment of severe carpal tunnel syndrome.改良卡米茨对掌成形术治疗重度腕管综合征。
J Hand Surg Eur Vol. 2018 Oct;43(8):889-891. doi: 10.1177/1753193418787666. Epub 2018 Jul 19.
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Extensor indicis proprius opponensplasty - the burkhalter revisited.示指固有伸肌对掌成形术——再探伯克哈特法
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