拇对掌功能重建的解剖学与临床应用研究
发布时间：2019-01-20 14:53
【摘要】：本论文通过研究拇对掌肌、拇短展肌的解剖学特点,观察拇短伸肌、拇长伸肌、尺侧腕伸肌的走行,建立尺侧腕伸肌-拇短伸肌腱移位术的解剖学模型并进行生物力学分析,以探求符合人体生理机制的拇对掌功能重建方法。解剖中我们发现拇对掌肌在拇对掌功能中很重要,其肌纤维方向与第一掌骨有成角,当其收缩时,垂直于第一掌骨方向的分力可牵拉第一掌骨旋前。而拇短展肌肌纤维方向同第一掌骨方向一致,主要使拇指外展。将尺侧腕伸肌移位至拇短伸肌腱后,其平行于第一掌骨方向的分力使拇指外展,而其垂直于第一掌骨方向的分力又可牵拉第1 掌骨使拇指旋前。这就解决了既往各种动力腱移位的拇对掌重建术拇指桡侧外展功能较好而旋前不足的问题。将拇短伸肌腱绕过拇长伸肌腱后再移位,在加大了拇指旋前角度的同时,也加强了拇指背侧关节囊,使拇指腕掌关节变得稳定。 并且我们将此方法成功应用于临床6 例拇对掌功能丧失的患者,术后重建效果良好。
[Abstract]:In this paper, we studied the anatomical characteristics of thumb palmar muscle and abductor pollicis brevis, observed the movement of extensor pollicis brevis, extensor pollicis longus and extensor carpi ulnaris, established the anatomical model of tendon transfer of extensor carpi ulnaris and extensor pollicis brevis, and made biomechanical analysis. Objective: to explore the reconstruction method of thumb palm function in accordance with the physiological mechanism of human body. In anatomy, we found that the palmar muscle of thumb is very important in the function of the palm of thumb, and the direction of the muscle fiber is angled with the first metacarpal bone, and when it contracts, the component force perpendicular to the direction of the first metacarpal bone can pull the first metacarpal reflex. The direction of the abductor pollicis muscle fiber is the same as the first metacarpal bone, which mainly makes the thumb abduction. After the extensor carpi ulnar muscle was transferred to the tendon of the extensor pollicis brevis, the branch force parallel to the direction of the first metacarpal made the thumb abduction, and its component force perpendicular to the direction of the first metacarpal could pull the first metacarpal bone to make the thumb pronate. This solves the problem of thumb radial abduction function and lack of pronation after thumb metacarpal reconstruction with all kinds of dynamic tendon translocation. The tendon of extensor pollicis brevis was bypassed by the tendon of extensor pollicis longus and then shifted. When the angle of pronation of thumb was increased, the capsule of dorsal joint of thumb was also strengthened to stabilize the carpometacarpal joint of thumb. This method was successfully applied to 6 patients with loss of thumb to palmar function.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R658;R322
本文编号：2412128
[Abstract]:In this paper, we studied the anatomical characteristics of thumb palmar muscle and abductor pollicis brevis, observed the movement of extensor pollicis brevis, extensor pollicis longus and extensor carpi ulnaris, established the anatomical model of tendon transfer of extensor carpi ulnaris and extensor pollicis brevis, and made biomechanical analysis. Objective: to explore the reconstruction method of thumb palm function in accordance with the physiological mechanism of human body. In anatomy, we found that the palmar muscle of thumb is very important in the function of the palm of thumb, and the direction of the muscle fiber is angled with the first metacarpal bone, and when it contracts, the component force perpendicular to the direction of the first metacarpal bone can pull the first metacarpal reflex. The direction of the abductor pollicis muscle fiber is the same as the first metacarpal bone, which mainly makes the thumb abduction. After the extensor carpi ulnar muscle was transferred to the tendon of the extensor pollicis brevis, the branch force parallel to the direction of the first metacarpal made the thumb abduction, and its component force perpendicular to the direction of the first metacarpal could pull the first metacarpal bone to make the thumb pronate. This solves the problem of thumb radial abduction function and lack of pronation after thumb metacarpal reconstruction with all kinds of dynamic tendon translocation. The tendon of extensor pollicis brevis was bypassed by the tendon of extensor pollicis longus and then shifted. When the angle of pronation of thumb was increased, the capsule of dorsal joint of thumb was also strengthened to stabilize the carpometacarpal joint of thumb. This method was successfully applied to 6 patients with loss of thumb to palmar function.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R658;R322
【参考文献】
相关期刊论文 前3条
1 李庆泰,王澍寰,张长清,徐刚;拇指正常对指角度的测量和临床应用[J];中华手外科杂志;2001年04期
2 成效敏,董震,顾玉东;拇对掌功能重建的新方法[J];中华手外科杂志;2003年04期
3 王利,宫云霞,梁智,朱小弟,李文庆,王文胜,陈传惶;大鱼际肌外伤性缺损的拇指对掌功能重建[J];中国修复重建外科杂志;2002年04期
，本文编号：2412128
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