【摘要】 目的介绍一种新的手术方法重建拇对掌功能。方法1992年7月～2002年1月,对46例正中神经损伤晚期致拇对掌功能丧失的患者进行拇短屈肌移位重建拇对掌功能。结果术后随访4～36个月,平均20个月。所有患者术后功能恢复率均达100%,未出现任何并发症及不良后果。结论拇短屈肌移位适用于手部正中神经损伤晚期的患者重建拇对掌功能,尤其适用于支配拇短屈肌深头的尺神经完好的患者。此方法手术损伤小,只需一个小切口;因不需游离肌腱移植,故不会影响手部其它功能;术后只需将拇指固定在对掌位置,不需将其它关节屈曲固定,因此其它手指及腕部的活动不受限制。更多还原

【Abstract】 Objective To introduce a new optimal operation for the reconstruction of thumb opposition in patients with late median nerve injury. Methods From July 1992 to January 2002, 46 patients of late median nerve injury with loss of thumb abduction were treated surgically by transposition of the flexor pollicis brevis muscle for the reconstruction of thumb opposition. There were 35 males and 11 females aging from 18 to 46 years with the average of 32 years. All of the patients suffered from median nerve injury and nerve repair had been undergone. The interval from injury to the second operation was 2.25 years ranging from 6 months to 4 years. Results All patients were followed up for 4-36 months with an average of 20 months. According to our functional evaluation system designed in 1992, the recovery ratio with favorable function was 100%, no complications and disadvantages were found. Conclusion The new optimal transpositional operation of the flexor pollicis brevis muscle for the reconstruction of thumb opposition is suitable for the patients with late median nerve injury, especially when the ulnar nerve branch to the deep head of the flexor pollicis brevis muscle is uninjured. This method has the following advantages: 1) Minimal operative trauma, only a small incision is required in contrast to the conventional method that need multiple incisions; 2)No other tendon transposition is needed, it does not interfere with other functions of the hand; 3) Postoperatively, it is unnecessary to keep many neighbouring joints in extreme flexion position, except for the thumb in opposition position, movements of all fingers and the wrist are not restrained.更多还原