桡侧腕长伸肌腱转位重建再植拇指伸指功能的临床应用

Transposition of extensor carpi radialis longus tendon in reconstruction of replantation thumb

目的探讨桡侧腕长伸肌腱转位重建再植拇指伸指功能的临床疗效。方法2009年3月至2013年9月，我们在11例旋转撕脱离断后再植拇指的二期功能重建中，采用桡侧腕长伸肌腱转位重建伸拇功能、环指指浅屈肌腱转位重建屈拇功能。结果所有患者切口均I期愈合，10例获得6～15个月的随访，1例失访，拇指屈伸功能恢复可，根据中华医学会手外科学会断指再植功能评定试用标准评定：优6例，良3例，差1例。结论在旋转撕脱离断后再植拇指的二期功能重建中，采用桡侧腕长伸肌腱转位重建伸拇的手术方法操作简单，术后能够满足伸拇要求，疗效满意。

Objective To discussion the clinical egfficacy of extensor carpi radialis longus tendon transposition in reconstruction of thumb extension. Methods From March 2009 to September 2013, 11 cases were treated with carpi radialis longus tendon transposition to recoustruct thumb extension and ring finger flexor hallucis superficial flexor tendon transposition to reconstruct thumb flexion. Results All 11 eases recovered well. 10 cases were follow-up for 6 to 15 months, and one case was lost. Thumb extension and flexion function obtained good recovery. According to the function evaluation standard of amputated finger replantation enacted by Hand Surgery Branch of Chinese Medical Association, 6 eases were excellent, 3 fine, and 1 poor. Conclusion Carpi radialis longus tendon transposition in reconstruction of thumb extension could be a simple method to reconstruct thumb function and achieve satisfactory clinical outcomes.