Department of Hand Surgery, Huashan Hospital, Shanghai 200040, China.
Chin Med J (Engl). 2013 Oct;126(20):3865-8.
Contralateral C7 (cC7) transfer had been widely used in many organizations in the world, but the outcomes were significantly different. So the purpose of the study was to evaluate the outcome of patients treated with cC7 transferring to median nerve and to determine the factors affecting the outcome of this procedure.
A retrospective review of 51 patients with total root avulsion brachial plexus injuries who underwent cC7 transfer was conducted. All of the surgeries were performed with two surgery stages and median nerve was the recipient nerve. The cC7 nerve was used in three different ways. The entire C7 root was used in 11 patients; the posterior division together with the lateral part of the anterior division was used in 15 patients; the anterior or the posterior division alone was used in 25 patients. The mean follow-up period was 6.9 years.
The efficiency of the surgery in these 51 patients was 49.02% in motor and 62.75% in sensory function. The patients with entire C7 root transfer obtained significantly better recovery in both motor and sensory function than the patients with partial C7 transfer. The best function recovery could be induced if the interval between the two surgery stages was 4-8 months.
cC7 transfer is an effective procedure in repairing median nerve. But using the entire C7 root transfer can obtain better recovery; so we emphasize using the entire root as the donor. The optimal interval between two surgery stages is 4-8 months.
对侧 C7（cC7）转移已在世界上许多机构中广泛应用，但结果却大相径庭。因此，本研究的目的是评估接受 cC7 转移至正中神经的患者的治疗效果，并确定影响该手术效果的因素。
对 51 例全根撕脱性臂丛神经损伤患者行 cC7 转移的回顾性研究。所有手术均分两期进行，正中神经为受神经。cC7 神经有三种不同的使用方式。11 例患者使用整个 C7 神经根；15 例患者使用后部分与前部分外侧部分；25 例患者仅使用前或后部分。平均随访时间为 6.9 年。
51 例患者手术的运动效率为 49.02%，感觉效率为 62.75%。与部分 C7 转移患者相比，使用整个 C7 神经根转移的患者在运动和感觉功能方面的恢复明显更好。两期手术间隔 4-8 个月，可获得最佳功能恢复。
cC7 转移是修复正中神经的有效方法。但使用整个 C7 神经根转移可获得更好的恢复，因此我们强调使用整个神经根作为供体。两期手术的最佳间隔时间为 4-8 个月。
