胸背神经移位术用于锁骨下臂丛神经损伤时的屈肘功能重建
Thoracodorsal nerve transfer for elbow flexion reconstruction in infraclavicular brachial plexus injuries.
作者信息
Soldado Francisco, Ghizoni Marcos F, Bertelli Jayme
机构信息
Department of Pediatric Upper Extremity Surgery and Microsurgery, Hospital Sant Joan de Deu, Universitat de Barcelona, Barcelona, Spain; Department of Neurosurgery, Center of Biological and Health Sciences, University of the South of Santa Catarina (Unisul), Tubarão, Brazil; Department of Orthopedic Surgery, Governador Celso Ramos Hospital, Florianópolis, Santa Catarina, Brazil.
Department of Pediatric Upper Extremity Surgery and Microsurgery, Hospital Sant Joan de Deu, Universitat de Barcelona, Barcelona, Spain; Department of Neurosurgery, Center of Biological and Health Sciences, University of the South of Santa Catarina (Unisul), Tubarão, Brazil; Department of Orthopedic Surgery, Governador Celso Ramos Hospital, Florianópolis, Santa Catarina, Brazil.
出版信息
J Hand Surg Am. 2014 Sep;39(9):1766-70. doi: 10.1016/j.jhsa.2014.04.043. Epub 2014 Jun 13.
PURPOSE
To report the clinical results of thoracodorsal nerve (TDN) transfer to the biceps nerve for elbow flexion restoration in infraclavicular brachial plexus injuries.
METHODS
Five male patients, mean age 33 years and affected with infraclavicular brachial plexus injuries, underwent a direct coaptation of the TDN to the nerve to the biceps an average of 8 months after injury. The procedure included the transfer of a branch of the TDN to the musculocutaneous nerve in 2 patients.
RESULTS
All patients achieved M4 elbow flexion strength according to the British Medical Research Council scale at a mean follow-up of 22 months.
CONCLUSIONS
Direct TDN transfer seems to be a useful surgical procedure for restoring elbow flexion in patients with infraclavicular brachial plexus injuries.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
目的
报告胸背神经（TDN）移位至肱二头肌神经以恢复锁骨下臂丛神经损伤患者肘关节屈曲功能的临床结果。
方法
5例男性患者，平均年龄33岁，患有锁骨下臂丛神经损伤，在受伤后平均8个月接受了TDN与肱二头肌神经的直接吻合术。该手术包括在2例患者中将TDN的一个分支移位至肌皮神经。
结果
所有患者在平均22个月的随访时，根据英国医学研究委员会量表均达到了M4级肘关节屈曲力量。
结论
直接TDN移位似乎是恢复锁骨下臂丛神经损伤患者肘关节屈曲功能的一种有用的手术方法。
研究类型/证据水平：治疗性IV级。
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