| 聂铭博,鲍远,张滋洋,等.多组神经移位治疗臂丛C5~C7根性撕脱伤重建肩外展及屈肘功能.骨科,2016,7(3): 145-148. |
| 多组神经移位治疗臂丛C5~C7根性撕脱伤重建肩外展及屈肘功能 |
| Multiple nerve transfer to rebuilt the shoulder abduction and elbow flexion after the avulsion of C5-C7 nerve roots |
| 投稿时间：2015-12-05 |
| DOI：DOI：10.3969/j.issn.1674-8573.2016.03.001 |
| 中文关键词: 臂丛 神经移位 周围神经 尺神经 |
| 英文关键词: Brachial plexus Nerve transfer Peripheral nerves Ulnar nerve |
| 基金项目:国家自然科学基金（81472106） |
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| 中文摘要: |
| 目的 观察联合应用多组神经移位治疗臂丛上、中干根性撕脱伤重建肩外展及屈肘功能的临床效果。方法 我科于2012年4月至2014年4月收治臂丛上、中干根性撕脱伤患者16例，采用副神经斜方肌肌支移位修复肩胛上神经、桡神经肱三头肌长头支移位修复腋神经肌支及尺神经部分束支移位肌皮神经（Oberlin术式），联合修复臂丛上、中干根性撕脱伤，以恢复肩外展及屈肘功能。术后随访采用臂肩手功能障碍（the disabilities of the arm, shoulder and hand, DASH）评分表评估疗效。结果 16例患者中有14例术后得到随访。随访时间为24~28个月（平均为25个月），患者肩关节外展恢复至75°~90°，恢复时间为9.0~18.0个月（平均为14.0个月）。屈肘恢复至100°~160°，恢复时间为4.0~7.5个月（平均为5.8个月）。DASH评分为8.0~16.0分，平均为14.6分。结论 使用多组神经移位联合治疗臂丛上、中干损伤，可较好恢复肩外展及屈肘功能，尺神经部分束支移位修复肌皮神经肱二头肌支对手内在肌功能无明显影响。 |
| 英文摘要: |
| Objective To observe the curative effect of the multiple nerve transfer to cure the disability of shoulder abduction and elbow flexion after the avulsion of C5-C7 nerve roots. Methods Sixteen cases of the avulsion of C5-C7 nerve roots were subjected to multiple nerve transfer to rebuilt the shoulder abduction and elbow flexion during April 2012 to April 2014. We transferred the accessory nerve to suprascapular nerve, the anconeus longus branch of radial nerve to the axillary nerve and ulnar nerve partial fascicle to the musculocutaneous nerve (Oberlin transfer), respectively. The curative effect was estimated by the DASH questionnaire. Results Fourteen out of 16 patients had been successfully followed up. The mean period of follow-up was 25 months (ranging from 24-28 months). The range of shoulder abduction was 75°-90° and the average recovery time was 14.0 months (ranging from 9.0-18.0 months). The range of elbow flexion was 100°-160° and the average recovery time was 5.8 months (ranging from 4.0-7.5 months). The mean value of DASH score was 14.6 (ranging from 8.0-16.0). Conclusion The multiple nerve transfer can successfully rebuilt the shoulder abduction and elbow flexion after the avulsion of C5-C7 nerve roots and the ulnar nerve partial fascicle to the musculocutaneous nerve will do no harm to the function of intrinsic muscles in hand. |
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