Tubiana R, Talke M
Handchirurgie. 1976;8(4):177-86.
Palliative treatment of intrinsic muscle paralysis aims at correcting the claw deformity and improving prehension. This treatment will vary according to whether the claw can be actively corrected or not, if M. P. hyperextension is blocked. In the first category it suffices to maintain M. P. joint flexion either by capsulodesis or tenodesis so that the long extensors can extend the interphalangeal joints. Tendon transfers are useful only to reinforce the flexion force of the fingers if there is an associated long flexor tendon paralysis. These transfers should be fixed to the proximal part of the proximal phalanx. If the claw is not actively correctable, associated cutaneous, tendinous or joint lesions must co-exist and these will demand priority treatment. Tendon transfers, if possible, aim to extend the distal phalanges and should be fixed distally on the extensor expansion, knowing however that this carries the risk of swan neck deformity.
内在肌麻痹的姑息治疗旨在纠正爪形畸形并改善抓握功能。根据爪形畸形是否能主动纠正、掌指关节过伸是否受阻，治疗方法会有所不同。在第一类情况中，通过关节囊固定术或腱固定术维持掌指关节屈曲就足够了，这样长伸肌就能伸展指间关节。如果伴有长屈肌腱麻痹，肌腱转移仅用于增强手指的屈曲力量。这些转移肌腱应固定在近节指骨的近端部分。如果爪形畸形不能主动纠正，则必然并存相关的皮肤、肌腱或关节病变，这些需要优先治疗。如果可能，肌腱转移旨在伸展远节指骨，应固定在伸肌扩张部的远端，但要知道这有导致鹅颈畸形的风险。
