Department of Neurosurgery, Ernst Moritz Arndt University, Greifswald, Germany.
Neurosurgery. 2011 Apr;68(4):1018-24; discussion 1024. doi: 10.1227/NEU.0b013e31820a548c.
Peripheral nerve palsy caused by torsional nerve injury is rare. Only a few patients have been reported in the literature. The etiology of this type of nerve lesion is poorly understood.
To report on 5 patients presenting with peripheral nerve palsy caused by a torsional nerve injury.
Five patients presented with 6 upper peripheral nerve palsy involving the axillary nerve (n = 2), musculocutaneous nerve (n = 2), radial nerve (n = 1), and suprascapular nerve (n = 1). There was no history of trauma in 3 patients, but in the other 2 patients, nerve palsy occurred after a traumatic event. Because of a lack of spontaneous recovery, surgical exploration was performed. Torsion of the whole nerve (n = 5) or only 1 fascicle (n = 1) was found. Epifascicular epineurectomy and detorsion, as well as resection of the torsion site with subsequent primary nerve suture, were performed in 3 lesions.
Good to excellent recovery of motor function was achieved in all 5 patients. In the last patient who presented with 2 nerve torsions, the follow-up period after the last surgery is too short to allow evaluation.
Although not a frequent event, torsional nerve injury should be taken into consideration when dealing with peripheral nerve injuries. Surgical exploration with detorsion or suture results in good recovery.
扭转性神经损伤导致的周围神经麻痹较为罕见，文献中仅报道了少数病例。此类神经损伤的病因尚不清楚。
报告 5 例因扭转性神经损伤导致的周围神经麻痹患者。
5 例患者均表现为 6 例上肢周围神经麻痹，涉及腋神经（n = 2）、肌皮神经（n = 2）、桡神经（n = 1）和肩胛上神经（n = 1）。3 例患者无外伤史，但另外 2 例患者在创伤事件后出现神经麻痹。由于缺乏自发性恢复，进行了手术探查。发现整条神经（n = 5）或仅 1 束（n = 1）扭转。对 3 处病变行神经外膜切开松解和扭转、扭转部位切除后行神经端端吻合术。
5 例患者的运动功能均获得了良好至极好的恢复。最后 1 例存在 2 处神经扭转的患者，最近一次手术后随访时间太短，无法进行评估。
虽然扭转性神经损伤并不常见，但在处理周围神经损伤时应考虑到这种损伤。松解或缝合神经后的探查手术可获得良好的恢复效果。
