Lu Laijin, Gong Xu, Liu Zhigang, Wang Dongsheng, Zhang Zhixin
Department of Hand Surgery, First Hospital Affiliated to Jilin University, Changchun 130021, China.
Chin J Traumatol. 2002 Dec;5(6):329-32.
To explore the diagnosis and operative treatment of radiation-induced brachial plexopathy.
Nine cases of radiation-induced brachial plexopathy were divided into two groups, 4 cases undergoing neurolysis of brachial plexus as Group A and 5 cases undergoing transfer of myocutaneous flaps after neurolysis as Group B. In Group B, 4 cases were treated with latissimus dorsi myocutaneous flaps (about 20 cm x 20 cm) and 1 case with pectoralis major myocutaneous flap (about 8 cm x 6 cm).
All the 9 cases of radiation-induced brachial plexopathy were followed up for a period of 2 to 5 years, with an average of 2.3 years. As far as pain relief and function recovery were concerned, the results of Group B were better than those of Group A.
Based on the results of Group B in the series, we suggest that the procedure of covering the wounds with transferred myocutaneous flaps after neurolysis of the brachial plexus should be performed to those advanced patients. The procedure may improve the blood supply of the fibrotic brachial plexus by reestablishing a good nerve bed.
探讨放射性臂丛神经损伤的诊断及手术治疗方法。
将9例放射性臂丛神经损伤患者分为两组，A组4例行臂丛神经松解术，B组5例行臂丛神经松解术后行肌皮瓣转移术。B组中，4例采用背阔肌肌皮瓣（约20 cm×20 cm），1例采用胸大肌肌皮瓣（约8 cm×6 cm）。
9例放射性臂丛神经损伤患者均获随访，随访时间2～5年，平均2.3年。在疼痛缓解和功能恢复方面，B组效果优于A组。
根据本系列B组的结果，我们建议对晚期患者行臂丛神经松解术后用转移肌皮瓣覆盖创面的手术。该手术可通过重建良好的神经床改善纤维化臂丛神经的血供。
