小指固有伸肌腱移位术后小指伸直障碍的防治

The prevention of straighten complication after grafting proper extensor muscle of fifth digit

目的 探讨小指固有伸肌腱移位术后小指伸直障碍的应用解剖学依据及其防治方法。方法针对小指伸肌腱行解剖学观察158例标本,并将伸向小指的指总伸肌腱束按生物力学分类为四型:即标准型、力线偏离度小型、力线偏离度大型及缺如型;针对术后小指伸直障碍,用腱间纤维联系切断术治疗 3例,术中预防性治疗 55例。结果 经 1年以上随访,1989年8月～1996年间的 54例病例中,3例术后发生小指伸直不全,经腱间纤维联系切断术后均治愈,此后,采用术中预防性治疗后未再发生小指伸直障碍。结论 小指固有伸肌腱移位术后小指伸直障碍与伸向小指的指总伸肌腱束的力线有关,按其类型分别采用腱间纤维联系切断术、腱短缩术及腱重建术,能够有效地防治小指伸直障碍的发生。

Objective To study the anatomic basis and the treatment of incomplete extension in grafting extensor digiti quinti.Methods 158 specimens were applied to study the anatomy of extensor tendon of small finger.We devided the extensor digiti communi (EDC) of small finger into 4 types .The amputation of intertendinous fascia was applied in 3 cases of postoperational incomplete-extensor and 55 cases of preventive treatment.Results The following-up was above a year. In 54 cases from Aug,1989 to 1996, 3 cases of incompelet extension in small finger were healed with amputation of intertendinous fascia. After adoptment of preventive treatment ,no cases came out imcomplete extension of small finger. Conclusion The incomplete extension after ten-dor-transferation operation is related to its extending -force way in small finger.The different operations are applied according to their types,including the amputation of intertendinous fascia, the shortening and reconstruction of tendor.