Tung Thomas H, Novak Christine B, Mackinnon Susan E
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
J Neurosurg. 2003 Feb;98(2):313-8. doi: 10.3171/jns.2003.98.2.0313.
In this study the authors evaluated the outcome in patients with brachial plexus injuries who underwent nerve transfers to the biceps and the brachialis branches of the musculocutaneous nerve.
The charts of eight patients who underwent an ulnar nerve fascicle transfer to the biceps branch of the musculocutaneous nerve and a separate transfer to the brachialis branch were retrospectively reviewed. Outcome was assessed using the Medical Research Council (MRC) grade to classify elbow flexion strength in conjunction with electromyography (EMG). The mean patient age was 26.4 years (range 16-45 years) and the mean time from injury to surgery was 3.8 months (range 2.5-7.5 months). Recovery of elbow flexion was MRC Grade 4 in five patients, and Grade 4+ in three. Reinnervation of both the biceps and brachialis muscles was confirmed on EMG studies. Ulnar nerve function was not downgraded in any patient.
The use of nerve transfers to reinnervate the biceps and brachialis muscle provides excellent elbow flexion strength in patients with brachial plexus nerve injuries.
在本研究中，作者评估了接受肌皮神经肱二头肌和肱肌支神经移位术的臂丛神经损伤患者的治疗结果。
回顾性分析了8例接受尺神经束移位至肌皮神经肱二头肌支以及单独移位至肱肌支的患者病历。采用医学研究委员会（MRC）分级结合肌电图（EMG）评估肘关节屈曲力量的治疗结果。患者平均年龄为26.4岁（范围16 - 45岁），受伤至手术的平均时间为3.8个月（范围2.5 - 7.5个月）。5例患者肘关节屈曲恢复为MRC 4级，3例为4+级。肌电图研究证实肱二头肌和肱肌均重新获得神经支配。所有患者的尺神经功能均未下降。
对于臂丛神经损伤患者，采用神经移位术使肱二头肌和肱肌重新获得神经支配可提供出色的肘关节屈曲力量。
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