前臂神经肌腱损伤的晚期治疗与功能重建

Late treatment and functional reconstruction for injuries of forearm nerves and tendons

目的总结前臂掌侧神经、肌腱损伤的晚期治疗与手功能重建的方法及疗效。方法对56例前臂掌侧神经、肌腱损伤术后的晚期患者，采用肌腱、神经松解，蚓状肌和拇对掌功能重建等方法进行修复。结果术后56例获得3．10个月（平均6个月）的随访，其中肌腱松解优良率为90％，蚓状肌功能重建优良率为88％，拇对掌功能重建优良率为90％。结论前臂掌侧血管、神经、肌腱损伤术后，依据不同的情况采用不同的方法进行重建，可以取得满意的临床效果。

Objective To evaluate the approaches and the effects of late surgical reconstruction of hand function after forearm nerve and tendon injuries. Methods Surgical reconstruction was performed in 56 patients with volar injuries of forearm nerves and tendons. Procedures included tenolysis, neurolysis, functional reconstruction of the lumbrieals and thumb opposition. Results Fifty-six patients were followed-up for 3 to 10 months （mean 6 months ）. Effective rate of tenolysis was 90%. Excellent lumbfieal muscle functional reconstruction was achieved in 88% of the eases, while excellent opponenplasty result was achieved in 90%. Conclusion Satisfactory clinical outcome can be achieved for volar injuries of forearm nerves and tendons through condition-dependent functional reconstruction.