背阔肌腱转移术用于恢复三角肌麻痹患者的肩部外展功能：一种新技术。
Latissimus dorsi tendon transfer to restore shoulder abduction in patients with deltoid paralysis: A novel technique.
作者信息
Moharram Ashraf N, Afifi Ahmed, Abdel-Wahed Mohamed, Ezzat Mostafa
机构信息
Hand and Microsurgery Unit, Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
出版信息
Shoulder Elbow. 2023 Feb;15(1):37-44. doi: 10.1177/17585732211053297. Epub 2021 Oct 25.
BACKGROUND
Shoulder abduction is an essential movement for placement of the hand in space and thus for upper limb function. The objective of this study was to introduce and test the effectiveness of a new technique of latissimus dorsi tendon transfer to deltoid insertion to restore shoulder abduction.
METHODS
We prospectively included 10 male patients with a lost deltoid function. Their mean age was 34.6 years (range, 25-46). We describe a new technique to compensate for the loss of the deltoid function using a latissimus dorsi tendon transfer augmented with a semitendinosus tendon graft. The tendon graft is passed over the acromion and attached to the anatomical deltoid insertion. Postoperatively, a shoulder spica in 90° abduction was used for six weeks followed by physiotherapy.
RESULTS
Patients were followed up for a mean of 25.4 months (range, 12-48). The mean range of active shoulder abduction rose to 110° (range, 90-140°) with a mean gain of 83° of abduction.
CONCLUSIONS
This procedure can be a useful technique for restoration of a significant range and strength of active shoulder abduction.
背景
肩部外展是将手置于空间中的一项基本动作，因此对于上肢功能至关重要。本研究的目的是介绍并测试一种新的背阔肌腱转移至三角肌止点以恢复肩部外展的技术的有效性。
方法
我们前瞻性纳入了10例三角肌功能丧失的男性患者。他们的平均年龄为34.6岁（范围25 - 46岁）。我们描述了一种使用背阔肌腱转移并辅以半腱肌腱移植来代偿三角肌功能丧失的新技术。肌腱移植片绕过肩峰并附着于解剖学上的三角肌止点。术后，使用外展90°的肩人字石膏固定六周，随后进行物理治疗。
结果
患者平均随访25.4个月（范围12 - 48个月）。主动肩部外展的平均范围增至110°（范围90 - 140°），外展平均增加83°。
结论
该手术对于恢复主动肩部外展的显著范围和力量可能是一种有用的技术。
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