【摘要】 目的对传统的胸大肌代肱二头肌的手术方法加以改进,进行组合肌移位,寻找重建屈肘功能的最佳治疗方法。方法切断胸大肌在肱骨的止点,在肱骨结节间沟顶端切断肱二头肌长头腱,然后向远端分离,显露至长头腱桡骨结节止点处,将前臂屈肌起点从肱骨内髁下方分离;将肱二头肌长头腱从前臂屈肌下方深面穿过,反折后穿过胸大肌止点,调整好张力再返回远端编结缝合。结果术后随访时间为1～5年,平均28.6个月。36例术前肘关节屈曲角度平均为7.2°,术后改善至106.6°,优良率达94.4%。结论组合肌移位重建屈肘功能,使整个屈肘肌力臂得到延长,杠杆力量加大。屈肘力量得到加强是重建屈肘功能较理想的治疗方法。更多还原

【Abstract】 Objective Modification of conventional pectoralis major to biceps brachii transfer by combined muscle transfer to improve treatment outcome of elbow flexion reconstruction.Methods The long head of biceps was eat on the top of intertubercular sulcus of humerus,and then dissected all the way to its distal end at radial tuberosity.Forearm flexor origin from the medial epicondyle was exposed to allow tunneling of the long head tendon underneath the flexor origin.The pectoralis major was cut at its insertion to the humerus and re- muted more distally along humerus.The reflected long head of the biceps was passed through the insertion of pectoralis major and woven together after temion adjustment.Results All patients were followed for 1 to 5 years,with an average follow-up of 28.6 months.The mean preoperative elbow flexion is 7.2°.Postoperatively it has been improved to 106.6°.Overall satisfactory rate was 94.4%.Conclusion The combined transfer increased moment arm of elbow flexion and hence make elbow flexion more efficient and powerful.It is an effective method to reconstruct elbow flexion.更多还原