Blaauw Gerhard, Slooff Albert C J
Department of Neurosurgery, University Hospital Maastricht, Maastricht, The Netherlands.
Neurosurgery. 2003 Aug;53(2):338-41; discussion 341-2. doi: 10.1227/01.neu.0000073420.66113.66.
To investigate the results of transfer of pectoral nerves to the musculocutaneous nerve for treatment of obstetric brachial palsy.
In 25 cases of obstetric brachial palsy (20 after breech deliveries), branches of the pectoral nerve plexus were transferred directly to the musculocutaneous nerve. For all patients, the nerve transfer was part of an extended brachial plexus reconstruction. Results were tested both clinically and with the Mallet scale, at a mean follow-up time of 70 months (standard deviation, 34.3 mo).
There were two complete failures, which were attributable to disconnection of the transferred nerve endings. The results after transfer were excellent in 17 cases and fair in 5 cases. Steindler flexorplasty improved elbow flexion for three patients.
Transfer of pectoral nerves to the musculocutaneous nerve for treatment of obstetric upper brachial palsy may be effective, if the specific anatomic features of the pectoral nerve plexus are sufficiently appreciated.
探讨将胸神经转位至肌皮神经治疗产瘫的效果。
25例产瘫患者（20例为臀位分娩后），将胸神经丛分支直接转位至肌皮神经。对所有患者而言，神经转位是臂丛神经扩大重建的一部分。在平均随访70个月（标准差34.3个月）时，采用临床检查和马利特量表对结果进行评估。
2例完全失败，原因是转位的神经末梢断开。转位后17例效果优秀，5例效果尚可。施泰德勒屈肌成形术改善了3例患者的肘关节屈曲功能。
如果充分了解胸神经丛的具体解剖特点，将胸神经转位至肌皮神经治疗产瘫性上臂麻痹可能有效。
