【摘要】 目的：探讨小指固有伸肌腱移位拇对掌功能重建术的优点、并发症及其处理方法。方法：采用以小指固有伸肌为力源，以尺骨下端尺侧缘为滑车，将移位腱分二束后，将其近侧束固定于拇掌指关节近侧拇长伸肌腱，而将另一束固定于拇掌指关节远侧拇长伸肌腱（津下法２３例）或将远侧束固定部位改为近节指骨桡背侧骨内（我们的改良法５８例）。其中后期１８例针对术后小指伸直不全，采用切断环、小指指总伸肌腱间腱联合的方法。结果：７２例术后随访平均２９个月，无明显并发症、效果满意者６６例，总满意率为９１６％ 。其中，早期５４例中发生小指伸直不全者３例、“鹅颈畸形”３例；后１８例采用切断环、小指指总伸肌腱间腱联合的方法后，无一例发生小指伸直不全现象。结论：在拇对掌功能重建术中，将小指固有伸肌腱可作为首选力源，但术后可能发生小指伸直不全，切断环、小指指总伸肌腱间腱联合的方法是预防该并发症的有效手段。术后发生的“鹅颈畸形”可以用改进移位固定部位的方法予以预防。更多还原

【Abstract】 Objective:To evaluate the advantages and the complications of transfer of extensor digiti guinti for the reconstruction of opponens pollicis function and the solution to the complications.Methods:We applied extensor digiti guinti as the donor and the ulnar side of the distal end of ulnar as the trochlea.The donor tendon was bifurcated into distal and proximal bands.The proximal band was sutured with the extensor pollicis longus over the proximal portion of the metacarpophalangeal (MP) joint and the distal band was sutured with the extensor pollicis over the distal portion of MP joint (Tsuke′s Method,23 cases) or the radial and dorsal part of the proximal phalanx (Our Modified Method,58 cases).In recent 18 cases,amputation of the junctrae tendinum between the 3 rd and 4 th branch tendons was carrtied out.Results:72 cases were followed up for 29 months on the average,and 66 patients,without complications,were satisfactory (91.6%).Three cases with incomplete extension of the small finger,and 3 cases with swan neck deformity were found in the earlier 54 cases.In recent 18 cases,amputation of the junctrae tendinum between the 3 rd and 4 th branch tendons was carried out,and no incomplete extension of small finger was found.Conclusion:The extensor digiti guinti can be considered as first choice for reconstruction of the opponens pollicis function.The complications were avoidable,such as incomplete extension of small finger which can be solved by amputation of junctrae tendinum and swanneck deformity which can be solved by modifying suture site of the distal band.更多还原