按骨骼肌亚部化和肌构筑学原理改进肌移植术重建伸膝功能

A modified operation of reconstructing the knee-extensor function according to the principle of muscular architecture and muscle compartmentalization

目的根据骨骼肌亚部化和肌构筑学原理探索改进重建伸膝功能的手术方法。方法对 5例小儿股四头肌麻痹病例采用半腱肌和股二头肌长头亚部移植术重建伸膝功能。结果股二头肌长头亚部的生理横切面积 (SA)为 18 0 7cm2 ,半腱肌为 13 2 4cm2 ,二者之和为 31 31cm2 ,与股中间肌的CSA 31 6 6cm2 相仿 ,可代替股中间肌的伸膝功能。已做手术 5例 ,疗效均满意。结论改进后的手术方法 ,即可防止髌骨脱位 ,又因保留股二头肌短头亚部于原位 ,从而保证了绳肌肌力 ,防止了膝反屈 ,是更符合解剖学原理的术式。

Objective [WT5”BZ]According to the principle of muscular architecture and muscle compartmentalization a modified operation was carried out in order to reconstruct the knee extensor function. [WT5”HZ]Methods [WT5”BZ]In five cases of quadriceps paralysis,the semitendinous and the long head of the biceps femoris were translocated to instead the function of the knee extensors. [WT5”HZ]Results [WT5”BZ]The cross sectional area(CSA) of the long head of biceps was 18.07cm,that of the semitendinous was 13.24cm,31.31cm in total,which was very similar to the CSA of the vastus intermedius (31.66),whose function was substituted by the formers.All five cases have recovered well. Conclusion The modified operation not only prevents the patella slipping, but also preserves the force of the hamstring. It was an operation more accord with anatomical concept. [WT5”HZ]