Tung Thomas H, Liu Daniel Z, Mackinnon Susan E
Division of Plastic & Reconstructive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8238, St. Louis, MO 63110, USA.
Hand (N Y). 2009 Jun;4(2):123-8. doi: 10.1007/s11552-008-9136-9. Epub 2008 Oct 9.
Radiation-induced brachial plexopathy is an uncommon but devastating late complication seen in patients receiving radiation therapy to the chest wall and axilla. Treatment options are unfortunately limited. We report a case of a 59-year-old woman treated with radiation therapy for breast cancer 12 years earlier, who presented with loss of elbow flexion and marked shoulder weakness. Electromyogram and intraoperative stimulation of the musculocutaneous nerve branches were consistent with a proximal motor nerve conduction block. Microsurgical transfer of median and ulnar nerve fascicles to the biceps and brachialis branches of the musculocutaneous nerve, respectively, were performed. The patient recovered MRC grade 4/5 elbow flexion after surgery. The characteristics of this disorder and surgical treatment options are reviewed.
放射性臂丛神经病变是一种罕见但严重的晚期并发症，见于接受胸壁和腋窝放射治疗的患者。不幸的是，治疗选择有限。我们报告一例59岁女性，12年前因乳腺癌接受放射治疗，现出现屈肘功能丧失和明显的肩部无力。肌电图和术中对肌皮神经分支的刺激结果与近端运动神经传导阻滞相符。分别将正中神经和尺神经束显微外科转移至肌皮神经的肱二头肌和肱肌分支。术后患者屈肘功能恢复至医学研究委员会（MRC）4/5级。本文对该疾病的特点和手术治疗选择进行了综述。
