本文選題：肌腱轉(zhuǎn)位術(shù)　切入點：橈神經(jīng)損傷　出處：《中國修復(fù)重建外科雜志》2017年05期 　論文類型：期刊論文

【摘要】：目的總結(jié)肌腱轉(zhuǎn)位術(shù)治療橈神經(jīng)損傷晚期功能障礙的療效。方法回顧分析2012年2月—2015年3月采用肌腱轉(zhuǎn)位術(shù)治療的12例橈神經(jīng)損傷晚期功能障礙患者臨床資料。其中男9例,女3例;年齡12~45歲,平均28歲。交通事故傷致肱骨干骨折并橈神經(jīng)離斷6例,肱骨內(nèi)固定物取出時醫(yī)源性損傷3例,機器絞傷致軟組織神經(jīng)缺損3例。一期手術(shù)均未行神經(jīng)修復(fù),術(shù)后12~18個月、平均14個月出現(xiàn)橈神經(jīng)損傷晚期功能障礙癥狀。其中橈神經(jīng)主干損傷8例,橈神經(jīng)深支損傷4例。術(shù)前患者均出現(xiàn)垂腕畸形,腕關(guān)節(jié)背伸肌力0級,屈曲肌力5級。結(jié)果術(shù)后患者切口均Ⅰ期愈合。12例均獲隨訪,隨訪時間6~12個月,平均8.5個月。末次隨訪時,患者腕關(guān)節(jié)背伸活動可、肌力3級,屈曲肌力4級。根據(jù)費起禮等和陳德松等療效評定法,獲優(yōu)7例,良3例,可2例,優(yōu)良率83.3%。結(jié)論肌腱轉(zhuǎn)位術(shù)治療橈神經(jīng)損傷晚期功能障礙臨床效果滿意。
[Abstract]:Objective to summarize the efficacy of tendon transposition in the treatment of late radial nerve dysfunction. Methods the clinical data of 12 patients with advanced radial nerve dysfunction treated by tendon transposition from February 2012 to March 2015 were retrospectively analyzed. Three cases were female, the age was 1245 years old (mean 28 years). 6 cases of fracture of the shaft of humerus caused by traffic accident, 3 cases of iatrogenic injury when the internal fixation of humerus were taken out. There were 3 cases of soft tissue nerve defect caused by mechanical strangulation. No nerve repair was performed at the first stage of operation. The symptoms of late functional disturbance of radial nerve injury occurred in 12 ~ 18 months postoperatively, in which there were 8 cases of radial nerve trunk injury. There were 4 cases of deep branch injury of the radial nerve. All the patients had the deformity of the wrists before operation. The wrist dorsal extensor muscle force was 0, and the flexion muscle strength was grade 5. Results all the patients were followed up for 6 ~ 12 months, all the incisions were healed in the first stage and 12 cases were followed up. The average time was 8.5 months. At the last follow-up, the wrist joints showed good dorsal extension activity, grade 3 muscle strength, and grade 4 flexion muscle strength. According to the evaluation method of Fei Kai Li et al and Chen Desong, 7 cases were excellent, 3 cases were good, 2 cases were fair. Conclusion the clinical effect of tendon transposition in the treatment of late radial nerve injury dysfunction is satisfactory.
【作者單位】： 安徽醫(yī)科大學(xué)附屬省立醫(yī)院骨科;
【分類號】：R688

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