- 期刊
Immediate Extensor Indicis Proprius Tendon Transfer for Avulsed Thumb Replantation-A Case Report
以伸食指肌腱轉移立即重建一撕脫性完全截斷拇指
摘要
背景：因為能提供較好的美觀及功能，針對斷指行再接植手術一直是治療上的優先選擇。然而，撕脫性斷指的處理，因為牽涉不同組織、不同程度的破壞，即使在顯微技術進步的現在，處理方式仍存在很多討論的空間，尤其針對的功能恢復。目的及目標：透過完整的報告一個術後功能恢復良好的個案，討論臨床上立即肌腱轉移在撕脫性截斷拇指的價值。材料及方法：一位二十歲的男性因工作受傷，導致左手拇指掌骨部位撕脫性截斷，在進行斷指再接植手術時，因拇指之伸拇長肌鍵自肌肉起端撕脫斷裂拉出，我們以食指之伸食指肌腱轉移立即重建完全撕脫斷裂之伸拇長肌腱。結果：病人術後沒有發生併發症，在復健後，回復到幾乎正常的拇指活動度。結論：拇指在手部功能很重要，拇指完全撕脫截斷的顯微再接植手術困難度頗高，在很嚴重的撕脫斷裂，肌腱常從肌肉起端撕脫斷裂拉出，造成肌腱無法直接修補。在此困難情形下，為讓再接植之拇指能早期復健，早期恢復，立即性肌腱轉移為一可行之選擇。
關鍵字
無資料並列摘要
Background: Replacing a severed thumb optimizes functional and esthetic outcomes, and every possible effort should be made to replant. However, avulsed amputation is considered a dilemma because it involves multiple-level, multiple-structure injuries. As microsurgical techniques become more refined, optimal management remains controversial, especially for the functional outcome of replantation. Aim and Objectives: This report presents a successful thumb replantation with immediate extensor indicisproprius (EIP) tendon transfer. Materials and Methods: A 20-year-old man presented a completely avulsed amputation of the left thumb at the proximal metacarpal bone. Immediate EIP tendon transfer was performed to reconstruct the avulsed extensor pollicislongus (EPL) tendon during replantation surgery. Results: The postoperative course was smooth. The patient had almost full range of motion on the interphalangeal (IP) and metacarpophalangeal (MP) joints, and full thumb opposition. No secondary procedures were necessary. Conclusion: For improving the functional recovery of thumb replantation, immediate tendon transfer for thumb avulsion amputation is a valuable alternative if primary tendon repair is not possible.
延伸閱讀
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