骨性手术在重度痉挛性脑瘫手部畸形治疗中的地位（附40例报告）

Valuation of the Bony Operation in Treat-ment of Severe Spastic Hand(A Report of40 Cases)

重度痉挛性脑瘫手部畸形功能重建是困难的。从１９８９年７月～１９９２年３月，我科在治疗这类病人中，本着不放弃手术机会，对具有骨性畸形废用之手４０只进行了腕、掌指、指间关节Ⅰ－Ⅱ掌骨融合、尺桡骨旋转截骨等骨性手术，同时松解挛缩肌腱，辅以屈肌转位代伸肌，使手畸形矫正、恢复功能位、改变外观，术后虽无抓举持握功能，但方便了穿脱衣袖，倒仆后可支撑地面，有的还获得了粗略功能，有效率为７２．５％。

Abstract The functionl reconstruction for the se-vere spastic hand with cerebral paralysis isdifficult.From July 1987 to March l992, 40hands treating with arthrodesis of car-pometacarpal. metacarpophalangeal,inter-metacarpal joint and theⅠ-Ⅱ metacarpal,rotation osteotomy of radius- ulna,relaxingthe contracted tendon and reconstruction ofthe extension muscle by flexion muscleswere performed.The results were correctionof the deformety,improvements of the ap-pearance. After the operation though thehand had no function of grasping and lift-ing,but it was convenient to dress and tak-ing off the coat.The patient can preventfrom severe fallen with his hands. Someonecan get some simple function. The effectiverate is 72.5%.