摘要
目的：针对胸腰段不稳定型骨折一脱位伴完全或不完合性截瘫患者，分别有选择性地进行肌替代术、关节固定术等，使病人重新获得站立或行走功能．方法：髋周肌瘫或不稳定者，采用改良Ober手术行同侧骶棘肌代臀大肌；膝不稳定者，采用腹外斜肌，腹直肌阔筋膜条代股四头肌；踝关节不稳定者采用腱固定、关节融合术或穿矫形高腰鞋．结果：本组12例胸腰椎骨折-脱位伴截瘫晚期患者，采用上述选择性肌替代术、关节固定术等，并指导病人术后积极进行肌力训练及关节功能锻炼．结果显示代肌组肌力可达Ⅱ-Ⅳ级，病人能够站立，扶与或弃拐行走．结论：作者认为肥替代术对胸腰椎骨折-脱位伴脊髓或马尾神经损伤晚期的病人，是一种有效和实用价值较大的治疗方法．
Aim:As to the special surgical methods were deviced including characteristic musclestransfer, arthrodesis etc. It makes the patients who sul'fer from unstable thoracolumber fractUre-dislocation with later complete or incomplete paraplegia stand or walk again. Methods.The advanced Oher'smethod which makes spinalissacral muscles origin transferred on the same lateral gluteus maximusmuscles were adopted on patients with hips muscles paraplegea and instability. Transfer of extendoblique muscle, rectus abdominls muscles on quadriceps were comducted on unstable knee cases; tendom fixation, orthrodeus kowe or high neck orthopaedic shoes were used in unstable ankle ones. ResultS f After characteristic muscles transfer and arthrodesis were cAned out, and the muscles and jointexericsing have been introduced in 12 later paraplegia cases who suffered from thoracolumber fracturedislocation, the insults showd that transferred muscles strength had been rehabilitated up to Ⅱ～Ⅳdegrees, which enable the patients to stand and walk by cane or not. ConclusiontAuthers suggest thatmuscles transfer is valubel and practicable method to reconsimct functions of paraplegia patients, whocontracted thoracolumbar fractUre-dislocation with advanced spinal cord or cauda eqtrina disorders.
出处
《伤残医学杂志》
1998年第1期47-50,共4页
Medical Journal of Trauma and Disability
关键词
胸腰段骨折
截瘫
功能重建
Thoracolumbar fractures
Paraplegia
Function reconstruct
