预构神经的趾短伸肌皮瓣移植重建第一背侧骨间肌功能

Transplantation of brevis extensor muscle of toes with prefabricated nerve to restore the function of first dorsal interosseous muscle

目的 探讨采用预构神经的趾短伸肌皮瓣移植重建第一背侧骨间肌功能的效果。 方法 本组 5例病人 ,男 2例 ,女 3例 ;年龄 17～ 2 4岁 ,平均 2 1岁。将正中神经的旋前方肌肌支用腓肠神经延长预构 ,待神经轴突长过预构神经后 ,再用带神经血管的趾短伸肌皮瓣移植 ,治疗尺神经损伤后第一背侧骨间肌纤维化。 结果 移植后 4～ 6周 ,所有病例临床显示其肌力均恢复到 2级以上 ,肌电图均出现移植肌肉动作电位。 7～ 9周后 ,所有病例第一背侧骨间肌功能均恢复到 4～5级。

Objective To study the therapeutic effect of the operation of restoring the function of the first dorsal interosseous muscle(FDIM). Methods The flap of brevis extensor muscle of toes(BEMT) with prefabricated nerve was used in the operation. Five cases of ulnar nerve lesions followed by the FDIM fibrosis were treated with the transplantation of the BEMT with prolongated prefabricated nerve. Results The FDIM strength regained 4～6 weeks after the therapy. Electromyogram study showed that the FDIM dominated nerve was the prefabricaede nerve. Conclusions The transplantation of the BEMT with prefabricated nerve is an effective way to restore the function of FDIM.