摘要
目的研究选择性胸小肌移植重建拇对掌功能术式的临床解剖基础及临床治疗的效果。方法在20侧成人尸体胸部及上肢标本上,观测和比较胸小肌及拇对掌肌的解剖数据,行移植模拟试验以评估新术式的可行性;依据解剖研究结果,按新的手术方式施行临床手术治疗5例,术后随访拇对掌功能恢复情况。结果解剖研究结果显示:胸小肌位置恒定,具备独立的动、静脉和神经支配;移植肌与受区对掌肌匹配;临床手术治疗5例,术后随访6～12个月,拇对掌功能恢复,肌力均达到4级以上,大鱼际部外形满意。结论胸小肌移植重建拇对掌功能这一术式有其临床解剖基础,移植手术能达到恢复对掌功能的要求,是一种新的对掌功能重建方法。
Objective To investigate a new surgical method by using pectoralis minor muscle for its partial transplantation to reconstruct the function of the opposite thumb anastomosed vessels and nerves. Methods The proposed method was evaluated by taking 20 cases of adult cadaveric thoraxes and hands, then compared with the morphology and dimension of both pectoralis minor muscle and palmer muscle to study the feasibility of the new method. Based on the observed data. We selected five suitable cases, in which the opposition function was lost, and then applied the new operation on them with partial transplantation of pectoralis minor muscle anastomosed vessels and nerves according to the results of anatomic study. The follow-up study was conducted to observe the functional recovery of opposition of the thumb. Results The main results can be summarized as follows. First, the anatomical position of pectoralis minor muscle was stable, and every pectoralis minor muscle was provided with self-sustaining artery, vein and nerve. The oppostition process of cadaveric hand succeeded after similar transplantation to clinic operation. Second, follow-up studies conducted 6 - 12 months after the operation showed that all five patients recovered fully. The muscle strength in all five cases recovered to level four or higher. The shape of palm eminence was satisfactory. Conclusion The surgical method of pectoralis minor muscle transplantation for reconstructing the opposition function of the thumb was based on the clinical and anatomical application. The function of opposition of the thumb reached the satisfactory requirement after the operation. So, the new surgical method can achieve better results than other existing operation methods.
出处
《中华显微外科杂志》
CSCD
北大核心
2007年第5期323-327,402,共6页
Chinese Journal of Microsurgery
基金
广东省深圳市科研立项(2005607491)
关键词
拇指
胸小肌
移植
对掌功能
显微外科
Thumb
Pectoralis minor
Transplantation
Opposition
Microsurgery
