Pronator teres is an appropriate donor muscle for restoration of wrist and thumb extension
Pronator teres is an appropriate donor muscle for restoration of wrist and thumb extension
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DOI：
10.1016/j.jhsa.2005.04.016
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发表时间：
2005-09-01
影响因子：
1.9
通讯作者：
Lieber, RL
中科院分区：
文献类型：
--
作者：
Abrams, GD;Ward, SR;Lieber, RL
目的：比较旋前圆肌（PT），桡侧腕短伸肌（ECRB），拇长伸肌（EPL）肌肉的详细建筑性能，以评估PT-ECRB和PT-EPL外科手术procedures.Methods的适用性：肌肉生理横截面积和特定区域的肌纤维长度进行了测量，在尸体PT，ECRB，EPL肌肉（n = 10肌肉的每种类型）。单因素重复方差分析的措施和事后t检验与Bonferroni校正被用于统计comparation.Results：尺骨头的PT是在10个标本中的8。平均PT纤维长度与ECRB相似（7.02 +/- 0.49 cm vs 6.17 +/- 0.27 cm），但显著长于EPL（5.44 +/- 0.25 mm）。PT肱骨头的纤维长度比尺骨头长（7.19 +/- 0.52 cm vs 4.14 +/- 0.25 cm）。PT的平均生理横截面积与ECRB相似（3.5 +/- 0.4 cm（2）vs 3.3 +/- 0.3 cm（2）），但显着大于EPL的（3.5 +/- 0.4 cm（2）vs 1.1 +/- 0.1 cm（2））。从结构的角度来看，PT是一个很好的供体选择，可以转移到ECRB以恢复腕关节伸展或转移到EPL以恢复拇指扩展名.然而，由于PT内存在纤维长度异质性，当尺骨头存在时，可能会限制供体肌肉的总位移。这些数据表明，在肌腱转移手术中，在转移前释放PT的尺骨头可能会导致这一重要运动的更大偏移。
Objective: To compare the detailed architectural properties of the pronator teres (PT), extensor carpi radialis brevis (ECRB), and extensor pollicis longus (EPL) muscles to evaluate the suitability of PT-to-ECRB and PT-to-EPL surgical procedures.Methods: Muscle physiologic cross-sectional areas and region-specific muscle fiber lengths were measured in cadaveric PT, ECRB, and EPL muscles (n = 10 muscles of each type). One-way repeated-analyses of variance measures and post hoc t tests with Bonferroni corrections were used for statistical comparisons.Results: The ulnar head of the PT was present in 8 of 10 specimens. The average PT fiber length was similar to that of the ECRB (7.02 +/- 0.49 cm vs 6.17 +/- 0.27 cm) but was significantly longer than that of the EPL (5.44 +/- 0.25 mm). Fiber length in the humeral head of the PT was longer compared with the ulnar head (7.19 +/- 0.52 cm vs 4.14 +/- 0.25 cm). The average physiologic cross-sectional area of the PT was similar to that of the ECRB (3.5 +/- 0.4 cm(2) vs 3.3 +/- 0.3 cm(2)) but was significantly larger than that of the EPL (3.5 +/- 0.4 cm(2) vs 1.1 +/- 0.1 cm(2)).Conclusions: From an architectural point of view the PT is an excellent donor choice for transfer to the ECRB for restoration of wrist extension or to the EPL for restoration of thumb extension. Because there is fiber length heterogeneity within the PT, however, when the ulnar head is present it may limit the total excursion of the donor muscle. These data suggest that releasing the ulnar head of the PT before transfer may result in larger excursions of this important motor in tendon transfer surgery.