摘要
目的研究观察重度腕管综合征伴拇对掌功能障碍者,在腕管松解的同时行掌长肌移位拇指对掌功能重建的手术疗效。方法1995～2 0 0 1年,对严格选择的重度腕管综合征伴拇指对掌功能丧失者9例,采用在腕管切开、神经松解的同时,行掌长肌移位拇指对掌功能重建术。术中将掌长肌腱游离至腕部附着处后用掌腱膜延长,在掌根部沿拇短展肌表面作皮下隧道,使掌长肌与拇短展肌成13 5°,将掌长肌止点缝合在拇指掌指关节的背桡侧。结果术后随访3～7个月,7例患者手麻症状全部消失,拇指对掌功能完全正常;2例患者拇指桡侧尚有轻度感觉减退,拇指对掌轻度受限,但拇指指尖可与小指指尖相对。结论腕管松解同时行拇指对掌功能重建手术,手术简便,拇指对掌功能的疗效可靠。
Objective To observe the treatment outcome of one stage carpal tunnel release and thumb opponensplasty for severe carpal tunnel syndrome. Methods 9 cases of severe carpal tunnel syndrome with loss of thumb opponens function were treated between 1995 and 2001. In addition to carpal tunnel release, thumb opponensplasty with palmaris longus transfer was done. Palmaris longus was harvested with palmar aponeurosis, tunneled subcutaneously along abductor pollicis brevis, and anchored to dorsoradial aspect of the first metacarpophalangeal joint at a 135° angle. Results All patients were followed for 3 to 7 months. Parasthesia disappeared in 7 patients who regained normal thumb opposition. Mild hypoesthesia on radial side of the thumb and mild limitation of thumb opposition were the results in the other 2 cases. Conclusion For severe carpal tunnel syndrome with loss of thumb opponens function, carpal tunnel release along with thumb opponensplasty is a simple and reliable method to restore opposition.
出处
《中华手外科杂志》
CSCD
北大核心
2005年第2期93-94,共2页
Chinese Journal of Hand Surgery
