Johnson D L, Gellman H, Waters R L, Tognella M
Rancho Los Amigos Medical Center, Downey, California 90242, USA.
J Bone Joint Surg Am. 1996 Jul;78(7):1063-7. doi: 10.2106/00004623-199607000-00011.
The brachioradialis tendon was transferred to the extensor carpi radialis longus and brevis tendons to restore active extension of the wrist in nine patients who had traumatic tetraplegia. The classification of neurological function was the fifth cervical level for all patients. The average time from the injury to the operation was six years (range, one to twenty years), and the average duration of follow-up was ten years (range, two to fifteen years). The evaluation of the patient included a determination of the preoperative and postoperative ranges of motion of the wrist, manual muscle-testing of the strength of the brachioradialis and the wrist extensors, a functional assessment of the ability to perform activities of daily living (eating, grooming, dressing, personal hygiene, and desktop activities [writing, typing, using a telephone, and so on]), and an assessment of functional independence. In addition, the result of the operation was evaluated subjectively by the patient. No patient had active extension of the wrist against gravity preoperatively. The strength of the wrist extensors improved postoperatively to a grade of good in six patients and to a grade of fair-plus in three. Function of the hand improved markedly in seven patients, and no patient had a loss of function. The patients had improvement in the ability to pick up objects, to feed and groom themselves, to tend to personal hygiene, to write and type, and to use a telephone.
将肱桡肌腱转移至桡侧腕长伸肌腱和桡侧腕短伸肌腱，以恢复9例创伤性四肢瘫痪患者的腕关节主动伸展功能。所有患者的神经功能分级均为颈5水平。受伤至手术的平均时间为6年（范围1至20年），平均随访时间为10年（范围2至15年）。对患者的评估包括测定术前和术后腕关节的活动范围、肱桡肌和腕伸肌力量的手法肌力测试、对日常生活活动能力（进食、修饰、穿衣、个人卫生及桌面活动[书写、打字、使用电话等]）的功能评估以及功能独立性评估。此外，由患者对手术结果进行主观评价。术前无患者能对抗重力主动伸展腕关节。术后6例患者腕伸肌力量改善至良好等级，3例改善至中等偏上等级。7例患者手部功能明显改善，无患者出现功能丧失。患者在拿取物品、自我喂食和修饰、进行个人卫生护理、书写和打字以及使用电话等能力方面均有改善。
