Post-Graduate Program in Medical Sciences, Unit of Neurosurgery, Hospital de Base do Distrito Federal, University of Brasília, Brasília, Distrito Federal, Brazil.
J Reconstr Microsurg. 2012 Mar;28(3):181-7. doi: 10.1055/s-0031-1301069. Epub 2012 Jan 24.
Some patients who sustain C5 to C7 nerve root injuries may demonstrate a natural recovery of elbow extension via the lower trunk; however the surgical effect of the reinnervation of the triceps brachii in such cases is still unknown. This study aims to determine the incidence of spontaneous recovery of the tricipital function and to identify the clinical and/or radiological predictors of poor spontaneous functional rehabilitation of elbow extension resulting from injuries of the upper roots of the brachial plexus. We conducted a review of the charts of 24 subjects sustaining an upper trunk syndrome with complete elbow extension palsy and who did not undergone any intervention for reinnervation of the triceps brachii in the primary brachial plexus surgery. Two years posttrauma, the muscle was scored as M0 in 12 patients (50%), M1 in 3 (12.5%), M2 in 1 (4.1%), M3 in 4 (16.6%), and M4 in 4 subjects (16.6%). The number of avulsed roots and the preoperative power of the latissimus dorsi did not demonstrate any significance in predicting the outcome of spontaneous elbow extension recovery; whereas the preoperative paralysis of the muscles for wrist extension was determined to be reliable predictive parameter for poor natural recovery of tricipital function.
一些 C5 至 C7 神经根损伤的患者可能会通过低级干自然恢复肘部伸展功能；然而，在这种情况下，三头肌的再神经支配的手术效果仍然未知。本研究旨在确定三头肌功能自发恢复的发生率，并确定导致臂丛上干损伤后肘部伸展功能不良的自发功能康复的临床和/或影像学预测因素。我们对 24 例在上干综合征中伴有完全肘部伸展麻痹且在初级臂丛手术中未进行任何三头肌再神经支配干预的患者的图表进行了回顾。外伤后 2 年，12 例患者（50%）的肌肉评分为 M0，3 例（12.5%）为 M1，1 例（4.1%）为 M2，4 例（16.6%）为 M3，4 例（16.6%）为 M4。撕脱根的数量和术前背阔肌的力量在预测自发肘部伸展恢复的结果方面没有显示出任何意义；然而，术前用于腕部伸展的肌肉瘫痪被确定为三头肌功能自然恢复不良的可靠预测参数。
