在自由运转的Gracilis肌肉转移中,肘部曲的最佳远距离肌插入点可用于腕损伤:一个尸体研究
Lomas S Persad1, Kitty Y Wu1, Alexander W Hooke1
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
The Journal of hand surgery
|July 22, 2023
概括
在腕受伤后恢复肘部曲是关键. 距离肌肌移动 (FFMT) 插入到 flexor digitorum profundus/brachioradialis肌中,比双肩插入更大的肘部曲强度.
科学领域:
- 整形外科手术 整形外科手术
- 重建性手术是一种重建性手术.
- 生物力学 生物力学
背景情况:
- 泛臂损伤往往需要重建性手术来恢复功能.
- 肘部曲是优先考虑的,Gracilis自由功能肌肉转移 (FFMT) 是一个可行的选择.
- 格拉西里斯FFMT可以插入双臂 (BIC) 或双臂 (BRD) 肌,用于肘部曲,或更远地插入 flexor digitorum profundus (FDP) 肌,用于联合肘部和手指曲.
研究的目的:
- 为了实验性地确定Gracilis FFMT插入到BIC,BRD和FDP肌的峰值瞬时矩臂.
- 为了比较不同gracilis FFMT插入点的生物力学有效性,用于肘部曲.
主要方法:
- 在三个新鲜冷的尸体样本上进行了六次模拟的Gracilis FFMT手术.
- 肌肌肉被转移到对侧上肢.
- 肘部曲/延伸是手动模拟的,即时动力臂是根据Gracilis外流和肘部关节角度计算的.
主要成果:
- 所有插入的峰值瞬时时刻臂发生在83°和92°的肘部曲之间.
- 与BIC插入相比,远端插入 (FDP/BRD) 产生了明显更大的 (大约1.5倍) 峰值瞬时矩臂.
- 动量臂的大小在33毫米到54毫米之间.
结论:
- 距离骨的FFMT插入部位 (FDP/BRD) 可能会增强重建的肘部曲强度.
- 这项研究提供了Gracilis FFMT瞬时动量臂的第一个实验量化.
- 这些发现支持远端FDP/BRD插入,为改善肘部曲扭矩的临床结果提供了定量解释.
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