Harvey L
Department of Physiotherapy, Prince Henry Hospital, New South Wales, Australia.
J Hand Ther. 1996 Jul-Sep;9(3):238-42. doi: 10.1016/s0894-1130(96)80087-1.
The effectiveness of a tenodesis grip is determined by the passive properties of the hand. An effective tenodesis grip can be achieved by encouraging a decrease in the resting length (i.e., adaptive shortening) of the flexor digitorum profundus and the flexor digitorum superficialis so that the fingers flex when the wrist is extended. Also, adaptive shortening of the flexor pollicis longus needs to be encouraged so that the thumb approximates the flexed fingers when the wrist is extended. The length of the adductor pollicis will in part dictate where along the radial side of the index finger the thumb will contact. Development of an effective tenodesis grip also requires that excessive metacarpophalangeal and interphalangeal joint stiffness of the fingers be prevented and that the interphalangeal joint of the thumb become stiff in extension. Careful management of the tetraplegic hand can ensure the development of the musculoskeletal changes necessary for an effective tenodesis grip.
肌腱固定抓握的有效性取决于手部的被动特性。通过促使指深屈肌和指浅屈肌的静息长度缩短（即适应性缩短），从而在腕关节伸展时手指能够屈曲，可实现有效的肌腱固定抓握。此外，还需促使拇长屈肌适应性缩短，以便在腕关节伸展时拇指能靠近屈曲的手指。拇收肌的长度在一定程度上决定了拇指在示指桡侧的接触位置。要形成有效的肌腱固定抓握，还需防止手指的掌指关节和指间关节过度僵硬，并且拇指的指间关节要在伸展时变得僵硬。对四肢瘫患者手部的精心管理能够确保形成有效肌腱固定抓握所需的肌肉骨骼变化。
