摘要
目的 将二足趾移植于前臂残端再造手指,利用再造手指控制多自由度电子假手治疗前臂部分缺失。方法 患者女性,19岁,右手及腕部在工作中不慎被机器碾碎,于腕上8cm行前臂截肢。取患者左足第二趾移植于前臂残端再造手指。移植术后二月,患者转入康复中心接受进一步康复训练。包括:①调整承重训练;②重量敏感性测试与训练;③手的稳定度测试与训练;④再造手指的控制能力测试与训练。结果 移植足趾存活良好。经过康复训练再造手指功能良好。指令控制测试中电子假手的准确度为100％。再造手指不仅能够准确地控制单自由度电子假手完成手指伸屈,而且能够精确地操纵三自由度电子假手完成假手手指的屈伸,以及腕关节的屈曲、背伸、旋前、旋后,有助于日常生活自理。结论 通过移植足趾于前臂残端,可以使电子假手达到100％的准确度。作者的报告为提高多自由度电子假手的控制准确度、减少误动作提供了有用的途径和范例。
Objective Treatment of the loss of part of the forearm by a multi - dimension - freedom electronic artificial hand, which is controlled by a reconstructed digit transplanted from the second toe to the forearm stump. Methods The female patient was 19 years old, whose right hand and wrist were crushed into pieces by machine at work and her forearm was amputated at the level of 8 cm proximal to the wrist. The second toe of her left foot was transplanted to reconstruct the digit onto the stump of her forearm. Two months after the transplantation, the patient was transferred to the rehabilitation center for further rehabilitation training, which consisted of : ①Training for adaptation to weight bearing. ②Testing and training of sensibility to weight. ③Testing and training for stability of the hand. ④Testing and training for the controlling function of the reconstructed digit. Results The transplanted toe survived well. After rehabilitation the reconstructed digit functioned well. In testing the performance under controlled mandate, the accuracy rate of the electronic artificial hand was 100% . The reconstructed digit was able not only to correctly operate the single - freedom electronic artificial hand in flexing or extending the digits but also to precisely manipulate the artificial digits, and in flexing, extending, pronating, or supinating the wrist joint to help herself in everyday life. Conclusion The 100% accuracy rate of the electronic artificial hand can be achieved by transplantation of the toe onto stump of the forearm. Our report provides a useful pathway and an example for the improvement of controlled accuracy of a multiple - freedom electronic artificial hand and reduction of false motion.
基金
国家自然科学基金资助(批准号395021)
关键词
再造手指
电子假手
再造手指控制的电子假手
前臂部分缺失
Reconstructed digit Electronic prothetci hand Electronic hand controlled by reconstructed digit
