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目的为解决胸小肌移植重建拇对掌功能术后出现拇指指骨间关节屈曲畸形提供解剖学依据并寻找解决办法。方法在15具尸体手标本上,使拇指处于对掌位时,测量拇指指骨间关节在拇短展肌未切断及切断两种情况下的自然屈曲角度;同时,通过外力作用使拇指指骨间关节分别屈曲处于45°及60°时,分析拇短展肌对拇指指骨间关节屈伸功能的影响。结果拇指处于对掌位时,拇短展肌在未切断及切断两种情况下,拇指指骨间关节自然屈曲角度分别为(13.30±2.13)°及(24.03±1.25)°;同时,使拇指指骨间关节屈曲处于45°时,所用外力分别约(0.50±0.08)N及(0.22±0.07)N,而使拇指指骨间关节屈曲处于60°时,所用外力分别约(1.48±0.09)N及(1.15±0.04)N。结论拇短展肌对拇指指骨间关节主要起背伸作用,因此胸小肌移植重建拇对掌功能时,应同时重建拇短展肌功能,才有可能纠正在拇对掌功能重建术后出现的拇指指骨间关节屈曲畸形。
Objective To provide an anatomical basis for finding the anatomical basis of thumb interphalangeal flexion deformity after reconstruction of thumb halberd muscle transplantation and to find a solution. Methods The natural flexion angle of the thumb interphalangeal joint under uncut condition and severed condition of the thumb extensor was measured in 15 cadaver hands with the thumb in the palm position. At the same time, the thumb interphalangeal joint At flexion of 45 ° and 60 ° respectively, the effect of thumb extensors on the flexion and extension of thumb interphalangeal joints was analyzed. Results When the thumb was on the palpation, the natural flexion angles of the thumb and interphalangeal joints were (13.30 ± 2.13) ° and (24.03 ± 1.25) °, respectively. In the same time, the thumb phalanges The external forces used were about (0.50 ± 0.08) N and (0.22 ± 0.07) N respectively when the intervertebral joint flexion was at 45 °, while the external forces used by the flexion of the interphalangeal joint at 60 ° were about (1.48 ± 0.09) N and 1.15 ± 0.04) N. Conclusions The thumb extensor muscle plays a dorsiflexive role in the thumb interphalangeal joint. Therefore, when the replantation of thumb halberds is performed on the pectoralis minor muscle, the function of the thumb extensor muscle should be reconstructed at the same time, which may correct the appearance of thumb metacarpophalangeal reconstruction The thumb phalangeal joint flexion deformity.