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[利用拇长伸肌恢复对掌功能。11年后回顾8例相关病例]

[Restoration of opposition using the extensor pollicis longus. Apropos of 8 cases reviewed after 11 years].

作者信息

Gerard P, Picard F, Moutet F, Guinard D, de Soras X

机构信息

Unité de Chirurgie réparatrice, de la Main et des Brûlés, Hôpital A. Michallon, Grenoble.

出版信息

Ann Chir Main Memb Super. 1994;13(5):328-33. doi: 10.1016/s0753-9053(05)80068-7.

Abstract

Moutet and coll. had studied in 1986 a series of 16 cases of restoration of thumb opposition by extensor pollicis longus transfer onto abductor pollicis brevis through the inter osseous membrane. Eleven years follow-up revision of 8 of those 16 patients was performed by the authors. Indication of transfer was traumatic median nerve isolated palsy or associated to ulnar nerve palsy. Objective and subjective analysed parameters allowed to check the evolution of the transfer and to justify its indications. No transfer retraction has been noted in long term follow-up. The side effects of its removal (thumb retropulsion and MP extension defects) have minimum functional consequences. The opposition has been restored at the time of thenarians recovery and as well, each time the palsy was going on. In the cases where the thenarians recovered, the transfer became an antepulsion supply. The authors suggest to perform an opposition transfer, each time it is technically possible, in severe median nerve lesions, at the time of emergency operation.

摘要

穆泰及其同事在1986年研究了16例通过拇长伸肌经骨间膜转移至拇短展肌来恢复拇指对掌功能的病例。作者对其中8例患者进行了11年的随访复查。转移术的指征为创伤性孤立性正中神经麻痹或合并尺神经麻痹。通过客观和主观分析参数来检查转移术的进展情况并证明其指征的合理性。在长期随访中未发现转移肌回缩情况。其移除的副作用(拇指后推和掌指关节伸展缺陷)对功能的影响最小。在大鱼际恢复时以及每次麻痹持续时,对掌功能均得以恢复。在大鱼际恢复的病例中,转移肌成为前推动力来源。作者建议,在严重正中神经损伤的急诊手术时,只要技术可行,应每次都进行对掌功能转移术。

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