Nicklas B J, Nicklas J S, Shields S L, Kovach K
Department of Surgery, Ohio College of Podiatric Medicine, Cleveland 44106, USA.
J Foot Ankle Surg. 1996 Nov-Dec;35(6):521-7. doi: 10.1016/s1067-2516(96)80124-4.
The purpose of this procedure was to salvage a first metatarsophalangeal joint after extensor hallucis longus tendon rupture, repair, re-rupture, and severe scarring in a 23-year-old female patient who originally underwent a bunionectomy and extensor hallucis longus tendon lengthening surgery. Initially, the existing functional tendon was surgically identified and freed from surrounding scar tissue, which provided only partial improvement. After this surgery, the patient exhibited only 30 degrees of active dorsiflexion of the first metatarsophalangeal joint with pain. To re-establish normal function, an artificial extensor hood apparatus (sling portion only) was later implanted into the first metatarsal head to augment function of the dorsiflexory power of the extensor hallucis longus. After reconstruction and implantation of an artificial extensor hood apparatus, the first metatarsophalangeal joint and extensor hallucis longus tendon have returned to normal function.
该手术的目的是挽救一名23岁女性患者的第一跖趾关节，该患者最初接受了拇囊炎切除术和拇长伸肌腱延长手术，之后拇长伸肌腱发生断裂、修复、再次断裂以及严重瘢痕形成。最初，通过手术识别出现有的功能性肌腱，并将其从周围瘢痕组织中松解出来，这仅带来了部分改善。此次手术后，患者第一跖趾关节的主动背屈仅为30度且伴有疼痛。为重建正常功能，后来在第一跖骨头处植入了一个人工伸肌罩装置（仅吊带部分），以增强拇长伸肌的背屈力量功能。在重建并植入人工伸肌罩装置后，第一跖趾关节和拇长伸肌腱已恢复正常功能。
