Pinzur M S, Wehner J, Kett N, Trilla M
Department of Orthopaedics and Rehabilitation, Loyola University Medical Center, Maywood, IL 60153.
J Hand Surg Am. 1988 Jul;13(4):549-52. doi: 10.1016/s0363-5023(88)80093-5.
Four patients with adult acquired spastic hemiplegic hand disorders had brachioradialis to extensor digitorum communis tendon transfer to establish motor balance and improve prehensile hand function. All of the patients had volitional control of the wrist and finger flexors without control of the finger extensors, producing a dynamic hand deformity in which the patients could initiate grasp without release. Dynamic electromyography in these patients revealed electrical activity of the brachioradialis muscle during active elbow extension, making a seemingly "out-of-phase" muscle available for "in-phase" tendon transfer. At follow-up, ranging from 26 to 36 months (average of 30.2 months), all four patients improved three functional levels. Translated to functional capacity all of the patients had no functional capacity before operation and good assistive prehension afterward.
4例成人获得性痉挛性偏瘫手障碍患者接受了肱桡肌至指总伸肌腱转移术，以建立运动平衡并改善手部抓握功能。所有患者的腕部和手指屈肌有自主控制能力，但手指伸肌无控制能力，导致一种动态手部畸形，即患者能够开始抓握但无法松开。这些患者的动态肌电图显示，在主动伸肘时肱桡肌有电活动，使得一块看似“不同步”的肌肉可用于“同步”肌腱转移。随访时间为26至36个月（平均30.2个月），所有4例患者的功能水平均提高了三个等级。从功能能力来看，所有患者术前无功能能力，术后辅助抓握功能良好。
