摘要
目的 观察并分析再造拇指在不同角度下与其他各指之间接触面积及捏力值之间有无改变及其规律,为再造拇指角度设定提供依据.方法 采用7例新鲜未固定手标本,于拇指近节中段离断,在拇指远节指腹正常角度00,旋前5°、10°、15°及旋后5°、10°、15°的情况下分别以克氏针固定,示、中、环指指深屈肌腱在2、4、6kg的拉力下测量与拇指间的捏力值;在4kg拉力下测量拇指在不同角度与示、中、环指间接触面积,对结果进行统计学分析.结果 拇指与示、中、环指间的捏力值在拇指不同旋转角度下及不同拉力值情况下差异均无统计学意义;拇指与示指间的接触面积在0°,旋前5°、10°及旋后5°时差异均无统计学意义;当旋后＜5°或旋前＞10°时对指面积减小,差异有统计学意义;拇指与中、环指间的接触面积在0°,旋前5°、10°、15°及旋后5°、10°时差异无统计学意义;当旋后15°时对指面积减小,差异有统计学意义.结论 再造拇指在不同角度固定对指间捏力无影响.拇指与示指间的接触面积在拇指旋前10°及旋后5°范围内无明显改变,超出此范围则接触面积减小,拇指与中、环指间的接触面积在拇指旋前15°及旋后10°范围内无明显改变,当拇指旋后15°时则接触面积减小.
Objective To analyze the relationship between thumb opposing angle and pinch strength of the thumb with the other fingers,and provide the theoretic basis for the best angle in thumb reconstruction.Methods Seven fresh cadaver hand specimens were used in the study.The thumb was severed in the middle of the proximal phalanx.It was re-attached with Kirschner wires at normal angle,5°,10° and 15° of pronation,and 5°,10° and 15° of supination.Thumb-to-finger pinch strength was measured when the flexor digitorum profundus of the index,long and ring fingers were pulled at 2,4 and 6 kg with an electronic pinch-strength gauge.The contact areas between the thumb and these three fingers at various angles with 4 kg pulling force were also measured using pressure sensitive films.The data were statistically analyzed.Results There were no significant differences in measurements of thumb-to-finger pinch strength with thumb positioned at various angles and fingers pulled with various forces.The contact area between the thumb and index finger did not change significantly when the thumb was at normal angle,5° and 10° of pronation,and 5° of supination.That contact area was significantly reduced when the thumb was positioned at ＜ 5° of supination or ＞ 10° of pronation.The contact area between the thumb and middle and ring fingers did not change significantly when the thumb was at normal angle,5°,10° and 15° of pronation,and 5° and 10° of supination.That contact area was significantly reduced when the thumb was positioned at ＞ 15° of supination.Conclusion Thumb-to-finger pinch strength is not affected by the angle at which the thumb is positioned in thumb reconstruction.Thumb-to-index finger contact area is not affected either within 10° of pronation and 5° of supination of the thumb.Beyond this range the contact area is reduced.Thumb-to-middle finger and thumb-to-ring finger areas are consistent within 15° of pronation and 10° of supination.The contact areas decrease when the thumb is at 15° of supination.
出处
《中华手外科杂志》
CSCD
北大核心
2014年第4期292-294,共3页
Chinese Journal of Hand Surgery
关键词
拇指
生物力学
角度
捏力
面积
Thumb
Biomechanics
Angle
Pinch strength
Size
