Deiler S, Wiedemann E, Stock W, Wilhelm K, Schweiberer L
Chirurgische Klinik, Klinikum Innenstadt, der Ludwig-Maximilians-Universität München.
Orthopade. 1997 Aug;26(8):684-9. doi: 10.1007/s001320050141.
Many modifications of tendon transfers have been described in the treatment of radial nerve palsy. Controversy persists over the muscles of choice to get the best results in motion of wrist and fingers. Patients with radial nerve palsy and treated by the method of Merle d'Aubigne in neurophysiological tests showed that the pronator teres did not work very well for extending the wrist. Thinking about the neurophysiologic principles it seemed that the flexor digitorum superficialis of the middle and ring fingers would make a better substitute for the wrist extension. From 1994 to 1997 four patients with radial nerve palsy had a transfer of the flexor digitorum superficialis tendons from the middle and ring fingers to the tendons of extensor carpi radialis longus and brevis additional the flexor carpi ulnaris and palmaris longus transfers. The functional recovery of two patients has been tested. The functional range of wrist motion of this two patients has been better than in patients with pronator teres transfers. It can be concluded that the new modification of tendon transfers is a good way of treatment of radial nerve palsy and should be done further.
在桡神经麻痹的治疗中，已经描述了许多肌腱转移的改良方法。对于选择哪些肌肉能在腕部和手指运动中取得最佳效果，仍存在争议。在神经生理学测试中，采用梅勒·德奥比涅方法治疗的桡神经麻痹患者显示，旋前圆肌在伸展腕部方面效果不佳。从神经生理学原理考虑，似乎中指和环指的指浅屈肌是更好的腕部伸展替代肌。1994年至1997年，4例桡神经麻痹患者接受了将中指和环指的指浅屈肌腱转移至桡侧腕长伸肌和桡侧腕短伸肌腱的手术，另外还进行了尺侧腕屈肌和掌长肌转移。对其中2例患者的功能恢复情况进行了测试。这2例患者的腕部运动功能范围比接受旋前圆肌转移的患者更好。可以得出结论，肌腱转移的新改良方法是治疗桡神经麻痹的一种好方法，应进一步开展。
