Department of Surgery, Division of Plastic & Reconstructive Surgery, Oregon Health and Science University, Portland, OR.
Tech Hand Up Extrem Surg. 2024 Mar 1;28(1):45-48. doi: 10.1097/BTH.0000000000000459.
Ulnar nerve injury initiates an imbalance between the intrinsic muscles and extrinsic extensors of the ring and small fingers, which leads to the characteristic hyperextension of the metacarpophalangeal (MP) joints and flexion of the proximal interphalangeal joints of these 2 digits-commonly referred to as the ulnar claw hand. In addition to these changes in the static posture of the hand, ulnar nerve palsy severely impairs grasp due to deficient active MP joint flexion. In most cases, motor balance can be restored by preventing MP joint hyperextension and augmenting MP joint flexion using the Zancolli lasso procedure (ZLP). Ulnar neuropathy can cause a second motor imbalance between the ulnar intrinsics and the extensor digit minimi leading to an abduction deformity of the small finger known as Wartenberg's sign. The inability to adduct the small finger can be a great source of frustration to patients. Using a cadaveric biomechanical model, we have developed a simple modification of the Zancolli lasso procedure that simultaneously corrects claw deformity and Wartenberg's sign and we report its efficacy in 2 clinical cases.
尺神经损伤会导致环指和小指的内在肌和外在伸肌之间失去平衡，导致掌指（MP）关节过度伸展和这两个手指的近节指间关节弯曲，通常被称为尺侧爪形手。除了手部静态姿势的这些变化外，尺神经麻痹还会严重损害抓握功能，因为主动 MP 关节屈曲不足。在大多数情况下，可以通过防止 MP 关节过度伸展和使用 Zancolli 套索术（ZLP）增强 MP 关节屈曲来恢复运动平衡。尺神经病变可导致尺侧内在肌和小指展肌之间的第二种运动不平衡，导致小指外展畸形，即 Wartenberg 征。小指不能内收会给患者带来很大的困扰。我们使用尸体生物力学模型，对 Zancolli 套索术进行了简单的改良，同时纠正了爪形畸形和 Wartenberg 征，我们报告了在 2 例临床病例中的疗效。
