【摘要】：本論文通過(guò)研究拇對(duì)掌肌、拇短展肌的解剖學(xué)特點(diǎn),觀察拇短伸肌、拇長(zhǎng)伸肌、尺側(cè)腕伸肌的走行,建立尺側(cè)腕伸肌-拇短伸肌腱移位術(shù)的解剖學(xué)模型并進(jìn)行生物力學(xué)分析,以探求符合人體生理機(jī)制的拇對(duì)掌功能重建方法。解剖中我們發(fā)現(xiàn)拇對(duì)掌肌在拇對(duì)掌功能中很重要,其肌纖維方向與第一掌骨有成角,當(dāng)其收縮時(shí),垂直于第一掌骨方向的分力可牽拉第一掌骨旋前。而拇短展肌肌纖維方向同第一掌骨方向一致,主要使拇指外展。將尺側(cè)腕伸肌移位至拇短伸肌腱后,其平行于第一掌骨方向的分力使拇指外展,而其垂直于第一掌骨方向的分力又可牽拉第1 掌骨使拇指旋前。這就解決了既往各種動(dòng)力腱移位的拇對(duì)掌重建術(shù)拇指橈側(cè)外展功能較好而旋前不足的問(wèn)題。將拇短伸肌腱繞過(guò)拇長(zhǎng)伸肌腱后再移位,在加大了拇指旋前角度的同時(shí),也加強(qiáng)了拇指背側(cè)關(guān)節(jié)囊,使拇指腕掌關(guān)節(jié)變得穩(wěn)定。 并且我們將此方法成功應(yīng)用于臨床6 例拇對(duì)掌功能喪失的患者,術(shù)后重建效果良好。
[Abstract]:In this paper, we studied the anatomical characteristics of thumb palmar muscle and abductor pollicis brevis, observed the movement of extensor pollicis brevis, extensor pollicis longus and extensor carpi ulnaris, established the anatomical model of tendon transfer of extensor carpi ulnaris and extensor pollicis brevis, and made biomechanical analysis. Objective: to explore the reconstruction method of thumb palm function in accordance with the physiological mechanism of human body. In anatomy, we found that the palmar muscle of thumb is very important in the function of the palm of thumb, and the direction of the muscle fiber is angled with the first metacarpal bone, and when it contracts, the component force perpendicular to the direction of the first metacarpal bone can pull the first metacarpal reflex. The direction of the abductor pollicis muscle fiber is the same as the first metacarpal bone, which mainly makes the thumb abduction. After the extensor carpi ulnar muscle was transferred to the tendon of the extensor pollicis brevis, the branch force parallel to the direction of the first metacarpal made the thumb abduction, and its component force perpendicular to the direction of the first metacarpal could pull the first metacarpal bone to make the thumb pronate. This solves the problem of thumb radial abduction function and lack of pronation after thumb metacarpal reconstruction with all kinds of dynamic tendon translocation. The tendon of extensor pollicis brevis was bypassed by the tendon of extensor pollicis longus and then shifted. When the angle of pronation of thumb was increased, the capsule of dorsal joint of thumb was also strengthened to stabilize the carpometacarpal joint of thumb. This method was successfully applied to 6 patients with loss of thumb to palmar function.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2005
【分類號(hào)】：R658;R322

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相關(guān)期刊論文 前3條

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本文編號(hào)：2412128