Okazaki M, Al-Shawi A, Gschwind C R, Warwick D J, Tonkin M A
Department of Hand Surgery and Peripheral Nerve Surgery, Royal North Shore Hospital, University of Sydney, St. Leonards, NSW, Australia.
J Hand Surg Eur Vol. 2011 Sep;36(7):535-40. doi: 10.1177/1753193411406477. Epub 2011 May 5.
This study evaluates the outcome of axillary nerve injuries treated with nerve grafting. Thirty-six patients were retrospectively reviewed after a mean of 53 months (minimum 12 months). The mean interval from injury to surgery was 6.5 months. Recovery of deltoid function was assessed by the power of both abduction and retropulsion, the deltoid bulk and extension lag. The deltoid bulk was almost symmetrical in nine of 34 cases, good in 22 and wasted in three. Grade M4 or M5* was achieved in 30 of 35 for abduction and in 32 of 35 for retropulsion. There was an extension lag in four patients. Deltoid bulk continued to improve with a longer follow-up following surgery. Nerve grafting to the axillary nerve is a reliable method of regaining deltoid function when the lesion is distal to its origin from the posterior cord.
本研究评估了采用神经移植治疗腋神经损伤的效果。对36例患者进行了回顾性研究，平均随访时间为53个月（最短12个月）。从受伤到手术的平均间隔时间为6.5个月。通过外展和后推力量、三角肌体积以及伸展滞后情况评估三角肌功能的恢复。在34例患者中，9例三角肌体积几乎对称，22例良好，3例萎缩。35例患者中，30例外展达到M4或M5*级，32例后推达到该级别。4例患者存在伸展滞后。术后随访时间延长，三角肌体积持续改善。当病变位于腋神经从后束发出点的远端时，对腋神经进行神经移植是恢复三角肌功能的可靠方法。
