Chim Harvey, Kircher Michelle F, Spinner Robert J, Bishop Allen T, Shin Alexander Y
Division of Hand Surgery, Department of Orthopedic Surgery, and.
J Neurosurg Pediatr. 2015 Jan;15(1):107-11. doi: 10.3171/2014.9.PEDS14245.
Transfer of the triceps motor branch has been used for treatment of isolated axillary nerve palsy in the adult population. However, there are no published data on the effectiveness of this procedure in the pediatric population with traumatic injuries. The authors reviewed demographics and outcomes in their series of pediatric patients who underwent this procedure.
Six patients ranging in age from 10 to 17 years underwent triceps motor branch transfer for the treatment of isolated axillary nerve injuries between 4 and 8 months after the inciting injury. Deltoid muscle strength was evaluated using the modified British Medical Research Council (MRC) grading system. Shoulder abduction at last follow-up was measured.
The mean duration of follow-up was 38 months. The average postoperative MRC grading of deltoid muscle strength was 3.6 ± 1.3. The median MRC grade was 4. One patient who did not achieve an MRC grade of 3 suffered multiple injuries from high-velocity trauma. Unlike in the adult population, age, body mass index of the patient, and delay from injury to surgery were not significant factors affecting the outcome of the procedure.
In the pediatric population with traumatic injuries, isolated axillary nerve injury treated with triceps motor branch transfer can result in good outcomes.
肱三头肌运动支移位已用于治疗成人孤立性腋神经麻痹。然而，关于该手术在创伤性损伤的儿科患者中的有效性，尚无公开数据。作者回顾了他们一系列接受该手术的儿科患者的人口统计学资料和治疗结果。
6例年龄在10至17岁之间的患者在致伤后4至8个月接受肱三头肌运动支移位术，以治疗孤立性腋神经损伤。使用改良的英国医学研究委员会（MRC）分级系统评估三角肌肌力。测量最后一次随访时的肩关节外展情况。
平均随访时间为38个月。术后三角肌肌力的平均MRC分级为3.6±1.3。MRC分级中位数为4级。1例未达到MRC 3级的患者因高速创伤而多处受伤。与成人不同，患者的年龄、体重指数以及受伤至手术的延迟时间并非影响手术结果的显著因素。
在创伤性损伤的儿科患者中，用肱三头肌运动支移位术治疗孤立性腋神经损伤可取得良好效果。
