손상에 의한 영구적 수부 장애에서의 건 이전술

Abstract

Impairment of hand function results from irreversible damage to the central nervous system, failure of repair to peripheral nerve injuries, and long-tam defects of muscles or tendons due to traumatic, congenital, infectious, or vascular causes. Thirty-six patients with impaired hands were treated surgically with tendon transfas and, if necessary, supplemer operations, The follow-up period after surgery was mean 2.1 years (range, 1.0-6.2 years). The causes of hand impairment were: musculotendinous defects, 13 cases; radial nerve injuries, 13; brachial plexus injury, 1; median nerve injuries, 3; ulnar nerve injury, 1; combined nerve injuries, 2; extensive burn, 1; and Volkmans ischemic conttactures, 2. Results of tendon transfer were: excellent, 13 cases; good, 16; fair 5; and poor, 2. Unstisfactory results derived from 2 extensive musculatendinous defects, 2 blockages of excursion of tendon due to adhesion, 1 uncorrected flexion contractures of digits, 1 multiple severe nerve injuries, 1 inadequate tension of tendon, 1 overcorrection of deformity, 1 infection, and 1 psychologic problem. Tendon transfer was considered to be effective and useful for functional mconstruction of impaired hands in selected patients. The supplementary operations extended indications of tendon transfer and were helpful in producing satisfactary results.