屈腕肌移位重建前臂旋后功能的应用解剖及临床应用

Applied Anatomy and Clinical Application in Rotatory Function Reconstruction of Forearm With Flexor Muscle of Wrist Transfer

目的:探索重建前臂旋后功能的动力肌,并在临床应用中验证其功能效果。方法:采用50例尸体上肢,经灌注后进行解剖、测量,观察尺侧腕屈肌和桡侧腕屈肌大体形态、血液供应及神经支配规律性,并设计临床手术方法,修复8例由于臂丛神经损伤后遗前臂旋后功能障碍,其中使用尺侧腕屈肌3例,桡侧腕屈肌5例。结果:8例平均随访3.6年,前臂总旋转活动度为125°～165°.旋后肌力为Ⅲ^+～Ⅵ级。均能完成日常生活及工作,对屈腕功能无明显影响。结论:尺侧或桡侧腕屈肌移位重建前臂旋后功能。均能达到良好功能恢复。

Objective: To probe the dynamic muscle to be reconstructed supination function of forearm, and to inspect its clinical results. Methods: Fifty cadaveric upper limbs were anatomized and measured after perfusion, it was observed that the gross morphology, blood supply and innervation regulation of ulnar and radial flexor muscle of wrist. Eight cases with supination dysfunction of forearm following brachial plexus nerve injury were repaired by ulnar flexor muscle of wrist transfer (3 cases) and radial flexor muscle of wrist transfer(5 cases). Results :Eight cases were followed up 3. 6 years in average, the total rotatory range of forearm was 125° to 165°, the supination myodynamia was Ⅲ+to Ⅵ degree. All the cases could work and perform daily life normally, and no obvious influence to flex the wrist. Conclusion:Ulnar or radial flexor muscle of wrist transfer to reconstruct supination function of forearm all can achieve good function recovery.