Search

指浅屈肌腱套索腱性固定术治疗爪形指畸形

目的 总结应用指浅屈肌腱套索腱性固定术矫正爪形指畸形的临床疗效。 方法 1990 年5 月－2005 年3 月，收治5 例单侧尺神经损伤致爪形指畸形患者。男4 例，女1 例；年龄28 ～ 37 岁。左侧3 例，右侧2 例。3 例腕部挤压伤，2 例前臂绞伤。病程21 ～ 37 个月，平均27.5 个月。Froment 征、Fowler 试验均为阳性。依据Stevens 标准分度均为重度神经损伤。经神经修复、松解治疗后，尺神经运动功能均无明显恢复。应用指浅屈肌腱套索腱性固定术，纠正爪形指畸形。 结果 5 例术后获随访，随访时间10 个月～ 11 年。掌指关节过伸、指间关节屈曲的畸形均得到矫正，无复发及并发症发生。环小指伸屈功能良好，但各指内收、外展功能无明显改善。 结论 指浅屈肌腱套索腱性固定术可矫正爪形手畸形，手术操作简便，损伤小，临床疗效较满意。

足母趾部分甲皱襞和甲床楔形切除治疗嵌甲

拇长伸肌腱自发性断裂的临床分析及治疗

Anatomical research of positional relationship between protective channel and sural nerve during Achilles tendon repair using channel assisted minimally invasive repair technique

Objective To evaluate the positional relationship between protective channel and sural nerve while treating acute Achilles tendon rupture with channel assisted minimally invasive repair (CAMIR) technique based on anatomical observations of cadaver specimens. Methods Twelve adult cadaveric lower limb specimens (6 left, 6 right) were utilized. A CAMIR device was implanted at a distance of 4 cm from the proximal end of the specimen to the Achilles tendon insertion. The skin was incised along the tendon’s medial side, the sural nerve was dissected, and the positional relationship with the protective channel was observed. The distance from the sural nerve-Achilles tendon intersection to the calcaneal insertion, the vertical distance between protective channel and the calcaneal insertion, and the horizontal distance between the sural nerve and protective channel were measured by using vernier caliper. Results Anatomical examination demonstrated a variable positional relationship between the sural nerve and protective channel, with the sural nerve positioned above (8 specimens) or below (4 specimens) the protective channel. The distance from the sural nerve-Achilles tendon intersection to the calcaneal insertion was (105.67±14.94) mm, the vertical distance between protective channel and the calcaneal insertion was (93.20±9.57) mm, and the horizontal distance between the sural nerve and protective channel was (0.31±0.14) mm. Conclusion The use of CAMIR technique for the treatment of acute Achilles tendon rupture can effectively avoid iatrogenic injury to the sural nerve.