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Re: Повреждение локтевого нерва
SAGo 22 Январь 2011, 23:03
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Если больной жалуется на функциональную недостаточность кисти и хирург может больному помочь, то это - не просто симптом, а уже ортопедическая проблема.
По поводу поперечного свода кисти.
Bell-Krotoski ( Bell-Krotoski JA. Preoperative and postoperative management of tendon transfers after ulnar nerve injury. In:Hunter JM, Mackin EJ, Callahan AD, eds. Rehabilitation
of the hand: surgery and therapy; Vol. II. 4th ed., St Louis:Mosby-Year Book, 1995: 729–751.):
“..the hypothenar muscle mass flexes, stabilizes, and brings into opposition the fourth and fifth metacarpals and ulnar two fingers and, with the thumb, enables the hand to cup the palm securely around objects. Loss of the intrinsic hypothenar muscles and resultant flattened or reversed metacarpal arch disrupts the grasping and securing power functions of the hand, leaving the patient to experience weakness and clumsiness in handling large objects’’
1. Bunnell S. Surgery of the intrinsic muscles of the hand other than those producing opposition of the thumb. J Bone Joint Surg 1942; 24: 1–31.
2. Littler JW. Tendon transfer and arthrodesis in combined median and ulnar nerve paralysis. J Bone Joint Surg 1949; 31A: 225–234.
3. Omer GE. Tendon transfers in combined nerve lesions. Orthop Clin North Am 1974; 5: 377–387.
4. Omer GE. Ulnar nerve palsy. In: Green DP, ed. Operative hand surgery; Vol. II. 3rd ed., New York: Churchill Livingstone, 1993: 1449–1466.
5. Palande DD. Correction of intrinsic-minus hands associated with reversal of the transverse metacarpal arch. J Bone Joint Surg 1983; 65A: 514–521.
6. Ranney DA. Reconstruction of the transverse metacarpal arch in ulnar palsy by transfer of the extensor digiti minimi. Plast Reconstr Surg 1973; 52: 406–412.
7. Ranney DA. The mechanism of arch reversal in surgically corrected claw hand. Hand 1974; 6: 266–272.
8. Goloborod’ko S.A. Restoration of opposition of the fifth finger of the hand. Scand J Plast and Reconstr Surg and Hand Surg 2004; V. 38, No. 2; 118 – 120.
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