Hand Malfunction after Improper Tendon Transfer - A Case Report

不適當肌腱轉移所造成的手功能障礙

林晉(Jinn Lin) ； 侯勝茂(Sheng-Mou Hou) ； 劉堂桂(Tang-Kue Liu)

《Journal of Orthopaedic Surgery Taiwan》 6卷3期 (1989/09) Pp. 140-145

摘要

不適當肌鍵轉移不但不能改善任何畸形，甚至會使手部原有的功能變壞。一位三十一歲的男性患者，在一次工廠之工作意外中，右上臂之正中神經遭受壓碎性傷害，他在外面一家醫院接受尺屈腕肌縫合到屈拇指長肌及第二屈指深肌的肌腱轉轉移手術。手術後，反而不能執行拇指與食指之捏挾動作及腕部屈曲動作。他在我們醫院接受再修症術。首先把原來縫合之處折開，然後以尺屈腕肌轉移至橈屈腕肌上來重建腕部屈曲。第二屈指深肌以邊至邊縫合到第三屈指探肌來使食指彎曲。拇指彎曲以臂橈肌轉移至屈姆長肌來取代，以伸食本肌繞行尺側轉移至拇外展短肌來完成拇指對掌功能。兩個月後，他能執行很好之捏挾及腕部屈曲動作。

並列摘要

Improper tendon transfer will not correct any deformity, and may in fact jeopardize had function. A 31 year-old male patient, who suffered crushing injury of right median nerve above elbow joint in a factorial accident, received tendon transfer of FCU to both FPL and FDPII by end to side suture at the other hospital. Regretfully he was unable to do thumb-to-index pinch. Additionally flexion of the wrist was impaired afterwards. Revisional operation was performed at our hospital. The original anastomosis was divided first. FCU was transferred to FCR to restor wrist flexion. FDPII was attached to FDPIII by side to side suture for index flexion. Thumb flexion was restored by transfer of brachoradialis to FPL.EIP was rerouted and transferred to APB for thumb opposition. As a result, he can do pinch and wrist flexion very well.

並列關鍵字

tendon transfer ； median nerve injury