主要上肢再植术后的自由功能肌肉转移

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-03-01 DOI:10.1016/j.jhsg.2024.07.008

Pedro C. Cavadas MD, PhD , Tina M.Y. Lee MBBS

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引用次数: 0

摘要

主要的上肢再植手术是一项复杂的手术，通常需要二次重建手术来改善功能。前臂关键功能肌群的丧失曾经被认为是再植的相对禁忌症。自由功能肌肉移植（FFMTs）的出现扩大了再植的界限。在这项研究中，我们试图回顾在主要上肢再植术后使用FFMTs的适应症、手术注意事项和结果。方法在这项回顾性研究中，我们纳入了接受前臂或近端截肢再植手术和随后进行FFMTs重建运动功能的患者。结果1998 - 2022年共16例患者接受了20次FFMTs治疗。这些都被用来重建手指的屈曲或伸展，或两者都有。所有患者在FFMT手术后都进行了二次手术以进一步增强功能预后。结论游离肌移植是上肢重植术后运动功能恢复的有效方法。研究类型/证据水平治疗性IV。

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Free-Functioning Muscle Transfers After Major Upper Limb Replantation

Purpose

Major upper limb replantation surgery is a complex undertaking that often requires secondary reconstructive procedures to improve function. The loss of critical functional muscle groups in the forearm was once considered a relative contraindication for replantation. The advent of free-functioning muscle transfers (FFMTs) has expanded the boundaries for replantation. In this study, we seeked to review the indications, surgical considerations, and outcomes of the use of FFMTs after major upper limb replantation.

Methods

In this retrospective study, we included patients who underwent replantation surgery for amputations at or proximal to the forearm and subsequent FFMTs for reconstruction of motor function.

Results

A total of 16 patients received 20 FFMTs between the period of 1998 and 2022. These were all used to reconstruct finger flexion or finger extension or both. All patients underwent secondary procedures to further augment functional outcomes after FFMT surgery.