Tendon Transfers for Median, Ulnar or Radial Nerve Palsy
Tendon Transfers for Median, Ulnar or Radial Nerve Palsy
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肌腱移植治疗正中神经、尺神经或桡神经麻痹
DOI：
10.1016/0072-968x(69)90039-4
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发表时间：
1969
期刊：
影响因子：
--
通讯作者：
D. Riordan
中科院分区：
文献类型：
--
作者：
D. Riordan
感觉的恢复将不被讨论，但在创伤性损伤中，神经修复必须先于任何肌腱转移。在神经损伤的初步修复后，或在疾病过程的早期，手必须通过某种形式的动态夹板保护。这种夹板防止畸形，并在外部取代瘫痪的肌肉功能，从而避免关节挛缩和肌腱和皮肤缩短的发展。如果一个人在神经损伤后很晚才出现挛缩，可能是肌肉不平衡的结果。必须通过适当的牵引夹板、锻炼和理疗来克服挛缩并恢复柔软的关节。在进行重建手术之前，必须恢复正常或接近正常的运动。在尝试重建手术之前，外科医生必须了解手的功能，并彻底了解手的复杂解剖结构。如果所有的内在肌肉都因创伤或疾病过程而瘫痪，就不可能完全恢复手的复杂运动。通常只能恢复张开手、抓握和对抗的基本功能。
Restoration of sensation will not be discussed but in traumatic lesions nerve repair must precede any tendon transfers. After the initial repair of nerve lesions, or early in a disease process, the hand must be protected by some form of dynamic splinting. This splinting prevents deformity and replaces the paralysed muscle function externally, thus avoiding the development of contractures of joints and shortening of tendons and skin. If a person is seen late after nerve injury contractures may have develeped as a result of the muscle imbalance. Contractures must be overcome and supple joints restored by appropriate traction splints, exercises and physiotherapy. Normal, or nearly normal motion must be restored before constructive procedures are undertaken.Before attempting reconstructive procedures the surgeon must understand the function and have a thorough knowledge of the intricate anatomy of the hand. It is not possible to restore the complicated movements of the hand fully if all the intrinsic muscles have been paralysed by the trauma or disease process. Only the basic functions of opening the hand, grasping, and opposition can usually be restored.