The University of Texas Southwestern Medical Center, Dallas, USA.
Hand (N Y). 2024 Jul;19(5):800-804. doi: 10.1177/15589447231153177. Epub 2023 Feb 14.
Techniques on opponensplasty for chronic carpal tunnel syndrome have been described previously. A novel pronator quadratus (PQ) transposition for chronic carpal tunnel syndrome is described. In addition, the relationship of the distal perforating branch of the radial artery to the surrounding tissue is detailed to optimize further use of the PQ flap for clinical applications.
Ten cadaver hands underwent PQ dissection, and the perforating branch of the radial artery was identified. Measurements were taken from the radiocarpal joint and the radial styloid to the distal perforating branch. Finally, a proposed surgical technique of PQ transposition with proximal radius periosteum to the first metacarpophalangeal joint and anterior interosseous nerve transfer was performed.
The average distance of the perforating branch from the radiocarpal joint was 10 ± 1.05 mm, and the average distance from the radial styloid was 17.1 ± 1.6 mm. Pronator quadratus transposed with a layer of radius periosteum demonstrated anatomical feasibility.
The distal perforating branch of the radial artery predictably perfuses the PQ muscle, which may be used in the future as a means of opponensplasty for chronic carpal tunnel syndrome.
先前已有关于慢性腕管综合征的对掌肌成形术技术的描述。本文描述了一种治疗慢性腕管综合征的新型旋前方肌（PQ）转位术。此外，详细描述了桡动脉远侧穿支与周围组织的关系，以进一步优化 PQ 皮瓣在临床应用中的使用。
10 只手的尸体进行了 PQ 解剖，确定了桡动脉的穿支。从桡腕关节和桡骨茎突到远侧穿支进行了测量。最后，提出了一种将 PQ 转位到第一掌骨间关节和骨间前神经的近端桡骨骨膜的手术技术。
穿支从桡腕关节的平均距离为 10±1.05mm，从桡骨茎突的平均距离为 17.1±1.6mm。用一层桡骨骨膜转位的旋前方肌具有解剖学可行性。
桡动脉的远侧穿支可预测性地为 PQ 肌肉供血，这可能在未来被用作慢性腕管综合征的对掌肌成形术的一种手段。
