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成人臂丛神经损伤的外科治疗

Surgical treatment of brachial plexus injuries in adults.

作者信息

Ricardo Monreal

机构信息

Orthopedics and Traumatology Department, Manuel Fajardo Teaching Hospital, Zapata y Calle D, Vedado, 10440, Havana, Cuba.

出版信息

Int Orthop. 2005 Dec;29(6):351-4. doi: 10.1007/s00264-005-0017-3. Epub 2005 Sep 29.

Abstract

We carried out a retrospective review of 32 consecutive patients (30 adults and two children) with total or partial lesions of the brachial plexus who had surgical repair using nerve grafting, neurotisation, and neurolysis between January 1991 and December 2003. The outcome measures of muscular strength were correlated with the type of lesion, age, preoperative time, length and number of grafts, and time to reinnervation of the biceps. The function of the upper limb was also evaluated. There was a significant correlation between muscular strength after surgical repair and both the preoperative time and the length of the nerve graft. There was also a significant correlation between muscular strength and the number of grafts. Muscular strength was better when the neurolysis was done before six months. When neurosurgical repair and reconstructive procedures were performed, the function of the upper limb was improved.

摘要

我们对1991年1月至2003年12月期间连续32例(30例成人和2例儿童)臂丛神经完全或部分损伤且接受了神经移植、神经移位和神经松解手术修复的患者进行了回顾性研究。肌肉力量的结果指标与损伤类型、年龄、术前时间、移植神经的长度和数量以及肱二头肌再支配时间相关。同时也评估了上肢功能。手术修复后的肌肉力量与术前时间和神经移植长度均存在显著相关性。肌肉力量与移植神经数量之间也存在显著相关性。在六个月前进行神经松解时,肌肉力量更好。当进行神经外科修复和重建手术时,上肢功能得到改善。

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