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垂直风洞中模拟自由落体后肌皮神经损伤:一例报告

Musculocutaneous nerve injury after simulated freefall in a vertical wind-tunnel: a case report.

作者信息

Mautner Kenneth, Keel John C

机构信息

Emory Orthopaedics and Spine Center, Atlanta, GA, USA.

出版信息

Arch Phys Med Rehabil. 2007 Mar;88(3):391-3. doi: 10.1016/j.apmr.2006.12.018.

Abstract

We report a case of a skydiver with isolated musculocutaneous nerve injury, which occurred after prolonged positioning of the arm during simulated freefall in a vertical wind-tunnel. Musculocutaneous nerve injury is rare, and the mechanism of isolated injury to this nerve is not entirely understood. Isolated peripheral nerve injuries such as this easily mimic other injuries and can be difficult to diagnose. The skydiver complained of right arm weakness and numbness that began after training in a vertical wind-tunnel. Exam revealed weakness in right elbow flexion and forearm supination, and diminished sensation in the right lateral forearm. Electrodiagnostic testing revealed a decreased amplitude in the right lateral antebrachial cutaneous nerve sensory nerve action potential, and fibrillations and positive sharp waves in the biceps and brachialis muscles. By 5 months, the subject reported complete sensory and motor recovery. Physical and electrodiagnostic findings corresponded to the distribution of the musculocutaneous nerve. The mechanism of injury was likely the prolonged abducted, extended, and externally rotated position of the shoulder during simulated freefall. Although isolated nerve injuries are uncommon, unusual activities and physiologic demands of athletes can result in such injuries. It is important to be aware of peripheral nerve injuries to facilitate proper diagnosis and management.

摘要

我们报告一例跳伞运动员孤立性肌皮神经损伤的病例,该损伤发生在垂直风洞中模拟自由落体时手臂长时间处于特定姿势之后。肌皮神经损伤较为罕见,且该神经孤立性损伤的机制尚不完全清楚。像这样的孤立性周围神经损伤很容易与其他损伤相混淆,诊断起来可能存在困难。该跳伞运动员在垂直风洞训练后出现右臂无力和麻木的症状。检查发现右肘屈曲和前臂旋后无力,右前臂外侧感觉减退。电诊断测试显示右前臂外侧皮神经感觉神经动作电位波幅降低,肱二头肌和肱肌出现纤颤电位和正锐波。到5个月时,该受试者报告感觉和运动功能完全恢复。体格检查和电诊断结果与肌皮神经的分布情况相符。损伤机制可能是模拟自由落体时肩部长期处于外展、伸展和外旋位。尽管孤立性神经损伤并不常见,但运动员的特殊活动和生理需求可能导致此类损伤。认识到周围神经损伤对于促进正确的诊断和治疗很重要。

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