Mohammad-Reda Ahmad
Zagazig University, Department of General Surgery, Plastic and Reconstructive Unit, Zagazig, Egypt.
Turk Neurosurg. 2013;23(1):1-9. doi: 10.5137/1019-5149.JTN.5654-11.3.
Treatment options for traumatic brachial plexus injuries include nerve grafting, or neurotization. The type of lesion and the reconstructive procedures affect functional results and postoperative pain relief.
A total number of twenty five patients suffering from post-traumatic brachial plexus injury were included in the study. The patients underwent exploration and primary repair of the affected plexus, based on case by case policy.
Spinal accessory nerve transfer to suprascapular nerve procedure regained 78.95% of functional muscle power, 10.50% of non functional muscle power and only 10.5 % of non innervated muscle. The Oberlin procedure regained 83.33% with elbow flexion muscle power, 16.67% with non functional muscle power. Intercostal nerve transfer to musculocutaneous nerve regained 62.5% with functional muscle power, 25% with non functional muscle power and only 12.5 % with non innervated muscle. The shoulder, elbow and wrist extension functions were significantly improved early post-operatively. In addition, the post-operative improvement of shoulder, elbow and wrist extension functions had significant negative correlations with the pre-operative elapsed time, and accompanied by a significant positive correlation with post-operative follow up period.
Early intervention for traumatic brachial plexus palsy is recommended to get good results with pain relief.
创伤性臂丛神经损伤的治疗选择包括神经移植或神经转位术。损伤类型和重建手术会影响功能恢复结果和术后疼痛缓解情况。
本研究纳入了25例创伤性臂丛神经损伤患者。根据具体病例情况，对受影响的神经丛进行探查和一期修复。
副神经转位至上肩胛下神经手术恢复了78.95%的功能性肌力、10.50%的非功能性肌力，而仅恢复了10.5%的失神经支配肌肉。奥伯林手术恢复了83.33%的屈肘肌力、16.67%的非功能性肌力。肋间神经转位至肌皮神经恢复了62.5%的功能性肌力、25%的非功能性肌力，仅恢复了12.5%的失神经支配肌肉。术后早期，肩部、肘部和腕部伸展功能有显著改善。此外，肩部、肘部和腕部伸展功能的术后改善与术前病程呈显著负相关，与术后随访时间呈显著正相关。
建议对创伤性臂丛神经麻痹进行早期干预，以获得良好的疼痛缓解效果。
