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| 題 名 | Half Extensor Digiti Minimi Transfer for Thumb Extension--Case Report=以部分伸小指肌肌腱轉移重建大拇指伸展功能--案例報告 |
|---|---|
| 作 者 | 吳俞鋒; 謝榮賢; 戴浩志; | 書刊名 | 臺灣整形外科醫學會雜誌 |
| 卷 期 | 28:3 2019.09[民108.09] |
| 頁 次 | 頁238-245 |
| 分類號 | 416.615 |
| 關鍵詞 | 伸小指肌; 肌腱轉移; 大拇指; Extensor pollicis longus rupture; EPL rupture; Extensor indicis proprius transfer; EIP transfer; Thumb extension; Extensor digiti minim transfer; EDM transfer; |
| 語 文 | 英文(English) |
| 中文摘要 | 背景:伸拇長肌肌腱斷裂若為慢性或斷端品質不佳無法直接重建時,以肌腱轉移重建大拇指伸展功能則是首選,其中又以伸食指肌肌腱轉移為最常使用之方式。其他肌腱轉移方式亦有文獻報告但多需額外之肌腱移植來延長不夠長之肌腱。本案例報告特別提出,在伸食指肌不適合轉移時,伸小指肌亦可作為轉移之肌腱來源而不需額外之肌腱移植。目的及目標:我們以一案例提出用部分之伸小指肌肌腱轉移,亦可有效重建大拇指伸展之功能。材料及方法:一名66歲修格蘭氏症候群患者左手腕挫傷消腫後,發生大拇指伸展功能喪失而前來就診。理學檢查及超音波檢查發現大拇指伸指長肌斷裂、伸食指肌部分斷裂。因此接受重建手術,以部分伸小指肌肌腱轉移至大拇指之伸指長肌重建大拇指伸展功能。因小指伸指肌功能不佳,故保留部分伸小指肌以維持小指伸展之功能。結果:門診復健及術後追蹤6個月,患者大拇指伸展功能良好,小指之伸展功能也無受損,且沒有已知之併發症。結論:以部分伸小指肌肌腱轉移重建大拇指伸指長肌之功能,在伸食指肌受損且沒有其他適合之肌腱可轉移時,是一可供選擇之方案。在適當的復健後,可恢復到相當好之大拇指伸展功能。 |
| 英文摘要 | Background: Tendon transfer is the favored surgical procedure when extensor pollicis longus (EPL) rupture is chronic or when quality of ruptured tendon end is poor. The extensor indicis proprius (EIP) and the palmaris longus (PL) are the most commonly used donor tendons for isolated EPL reconstruction. Other alternatives have been reported but additional tendon graft is needed for inadequate tendon length. This case report is featured with using extensor digiti minim (EDM) as an alternative donor for thumb extension. Aim and Objectives: In this paper, we report first successful half-EDM tendon transfer for restoration of thumb extension. Materials and Methods: The 66-year-old lady with Sjogren’s syndrome suffered from left wrist contusion injury. Lack of left thumb extension was noted after pain and swelling subsided. Ultrasonic examination showed EPL complete rupture and partial tear of EIP at carpometacarpal (CMC) joint level. Surgical reconstruction with half of EDM tendon transfer to EPL to restore thumb extension. Remained half of EDM was preserved for small finger extension due to weak and hypoplastic EDC to small finger. Results: The patient could extend her left thumb interphalangeal and metacarpophalangeal joints completely. The small finger extension function is intact. There were no complications during follow up for 6 months. Conclusion: Half of EDM transfer in a patient with traumatic loss of EPL is an alternative option for EPL reconstruction if no other potential tendon donor is suitable. After meticulous rehabilitation and regular follow up, the patient could have good thumb extension function recovery. |
本系統中英文摘要資訊取自各篇刊載內容。