桡侧腕屈肌与尺侧腕屈肌肌腱转移治疗高桡神经麻痹手指伸展的比较

S. Sen, N. K. Datta, Dipendra Misra, Zahidul Hak Khan, J. Islam, Susmita Sen, R. M. Chowdhury, K. Das
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摘要

高桡神经麻痹后,由于手腕、手指和拇指掌指关节的伸展能力丧失,手部握力严重受损。如果桡神经在保守或手术修复后在最佳时间内未显示神经恢复,肌腱转移被认为是标准治疗。目的:评价和比较桡侧腕屈肌腱与腕屈肌腱转移治疗高桡神经麻痹患者手指伸直的临床效果。这项随机对照试验研究于2013年1月至2014年12月在达卡Bangabandhu Sheikh Mujib医科大学骨科进行,为期两年。选取30例高桡神经麻痹患者,15例行桡侧腕屈肌腱转移术(FCR组),其余15例行尺侧腕屈肌腱转移术(FCU组)。术后随访12周。两组患者中男性占86.7%。FCR组平均年龄为31.07±9.14岁,FCU组平均年龄为33.60±10.79岁。肱骨骨折仍然是FCR组和FCU组桡神经麻痹的主要原因(26.7%对33.3%)。在第12周的最后随访中,未观察到MCP关节伸展缺陷(93.3%比80.0%,p>0.05)。两组手术干预的最终结果均满意(86.7%)。在高位桡神经麻痹的情况下,FCR和FCU肌腱转移手术对MCP关节的手指伸展是有效的。孟加拉国医学杂志2019年9月;48 (3): 9-15
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison between Flexor Carpi Radialis and Flexor Carpi Ulnaris Tendon Transfer for Fingers’ Extension in High Radial Nerve Palsy
The hand grip is severely impaired following high radial nerve palsy due to loss of extension of the wrist, metacarpo- phalangeal joint of fingers and thumb. If radial nerve does not show neural recovery following conservative or surgical repair during the optimum time, tendon transfer is considered the standard treatment. To evaluate and compare the clinical outcome between flexor carpi radialis and flexor carpiulnaris tendon transfer for fingers’ extension in high radial nerve palsy. This randomized controlled trial study was carried out in the Department of Orthopedic Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka over a period of two years from January 2013 to December 2014. A total of 30 patients with high radial nerve palsy were recruited, 15 patients were gone through Flexor Carpi Radialis tendon transfer procedure (FCR group) and the rest 15 patients were gone through Flexor Carpi Ulnaris tendon transfer procedure(FCU group). The patients were followed up for 12 weeks after surgical intervention. Out of all patients, 86.7% male were encountered in each group. The mean age was found 31.07±9.14 years in FCR group and 33.60±10.79 years in FCU group. Humerus fracture was remained a major cause of radial nerve palsy in both FCR and FCU groups (26.7% vs. 33.3%). In final follow-up at 12th week, no extension deficit was observed at MCP joint (93.3% vs. 80.0%, p>0.05).The end result of surgical intervention was found satisfactory equally in both the groups (86.7%). In case of high radial nerve palsy, both FCR and FCU tendon transfer procedures are effective forfingers’ extension at MCP joint. Bangladesh Med J. 2019 Sep; 48 (3): 9-15
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