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成人臂丛神经损伤中的神经移位:我的方法。

Nerve transfers in adult brachial plexus injuries: my methods.

作者信息

Chuang David Chwei-Chin

机构信息

Department of Plastic Surgery, Chang Gung University Hospital, 199 Tun Hwa North Road, Taipei-Linkou, Taipei (105), Taiwan.

出版信息

Hand Clin. 2005 Feb;21(1):71-82. doi: 10.1016/j.hcl.2004.10.004.

Abstract

The reconstructive strategies for avulsion in-juries vary from patient to patient and over time,continue to evolve depending on the surgeon's philosophy, available facilities and therapy, the elapsed time from injury to intervention, the severity of injury, and patient age and motivation. The author's results show that nerve transfer can obtain an average of 60 degrees (range, 20 degrees - 180 degrees) of shoulder elevation without shoulder arthrodesis, M3 to M4 muscle strength of elbow flexion, M2 to M4 elbow extension, and M3 finger flexion and sensation. Intrinsic hand function was obtained with help of dynamic splinting for interphalangeal joint extension and arthrodesis of thumb joints asa post for opposition.

摘要

撕脱伤的重建策略因患者而异,且随着时间推移不断演变,这取决于外科医生的理念、可用设备和治疗方法、受伤至干预的时间间隔、损伤的严重程度以及患者的年龄和积极性。作者的研究结果表明,神经移位术在不进行肩关节融合的情况下,平均可使肩部抬高60度(范围为20度至180度),屈肘肌力达到M3至M4级,伸肘肌力为M2至M4级,手指屈曲肌力为M3级,并恢复感觉功能。通过使用动力夹板辅助指间关节伸展以及拇指关节融合作为对掌支柱,可恢复手部固有功能。

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