University of Virginia, Charlottesville, Virginia.
Sports Health. 2009 Sep;1(5):370-5. doi: 10.1177/1941738109343544.
Severe brachial plexus injuries are rare in sports, but they have catastrophic results with a significant loss of function in the involved upper extremity. Nerve root avulsions must be timely managed with prompt evaluation, accurate diagnosis, and surgical treatment to optimize the potential for a functional outcome. This case report describes the mechanism of injury, diagnostic evolution, surgical management, and rehabilitation of a college football player who sustained a traumatic complete nerve root avulsion of C5 and C6 (upper trunk of the brachial plexus). Diagnostics included clinical evaluation, magnetic resonance imaging, computed tomography myelogram, and electromyogram. Surgical planning included nerve grafting and neurotization (nerve transfer). Rehabilitation goals were to bring the hand to the face (active biceps function), to stabilize the shoulder for abduction and flexion, and to reduce neuropathic pain. Direct current stimulation, bracing, therapeutic exercise, and biofeedback were used to maximize the use of the athlete's upper extremity. Although the athlete could not return to sport or normal function by most standards, his results were satisfactory in that he regained an ability to perform many activities of daily living.
严重的臂丛神经损伤在运动中较为罕见，但会导致受累上肢功能严重丧失，后果严重。神经根撕脱伤必须及时进行处理，包括及时评估、准确诊断和手术治疗，以优化功能恢复的潜力。本病例报告描述了一名大学生橄榄球运动员的损伤机制、诊断进展、手术处理和康复过程，该运动员发生了 C5 和 C6（臂丛神经上干）的外伤性完全神经根撕脱。诊断包括临床评估、磁共振成像、计算机断层脊髓造影和肌电图。手术计划包括神经移植和神经再支配（神经转移）。康复目标是使手能够触及面部（主动二头肌功能）、稳定肩部进行外展和屈曲，并减轻神经性疼痛。直流电刺激、支具、治疗性运动和生物反馈被用于最大限度地利用运动员的上肢。尽管该运动员无法达到大多数标准的重返运动或正常功能，但他的结果令人满意，因为他恢复了许多日常生活活动的能力。
