Cho Alvaro Baik, Iamaguchi Raquel Bernardelli, Silva Gustavo Bersani, Paulos Renata Gregorio, Kiyohara Leandro Yoshinobu, Sorrenti Luiz, de Menezes Klícia de Oliveira Costa Riker Teles, de Rezende Marcelo Rosa, Wei Teng Hsiang, Mattar Júnior Rames
Instituto De Ortopedia E Traumatologia Do Hospital Das Clínicas, Da Faculdade De Medicina - University of São Paulo, São Paulo, SP, Brazil.
Hospital Estadual Mario Covas, Faculdade De Medicina Do ABC, Santo André, SP, Brazil.
Microsurgery. 2015 Sep;35(6):428-31. doi: 10.1002/micr.22453. Epub 2015 Jul 21.
The purpose of this report is to critically evaluate our results of two intercostal nerve transfers directly to the biceps motor branch in complete traumatic brachial plexus injuries. From January 2007 to November 2012, 19 patients were submitted to this type of surgery, but only 15 of them had a follow-up for ≥2 years and were included in this report. The mean interval from trauma to surgery was 6.88 months (ranging from 3 to 9 months). Two intercostals nerves were dissected and transferred directly to the biceps motor branch. The mean follow-up was 38.06 months (ranging from 24 to 62 months). Ten patients (66.6%) recovered an elbow flexion strength ≥M3. Four of them (26.66%) recovered a stronger elbow flexion ≥M4. One patient (6.25%) recovered an M2 elbow flexion and four patients (26.66%) did not regain any movement. We concluded that two intercostal nerve transfers to the biceps motor branch is a procedure with moderate results regarding elbow flexion recovery, but it is still one of the few options available in complete brachial plexus injuries, especially in five roots avulsion scenario.
本报告的目的是严格评估我们在完全性创伤性臂丛神经损伤中，将两根肋间神经直接转移至肱二头肌运动支的手术结果。2007年1月至2012年11月期间，19例患者接受了此类手术，但其中只有15例获得了≥2年的随访，并被纳入本报告。从创伤到手术的平均间隔时间为6.88个月（范围为3至9个月）。解剖两根肋间神经并直接转移至肱二头肌运动支。平均随访时间为38.06个月（范围为24至62个月）。10例患者（66.6%）恢复了≥M3级的屈肘力量。其中4例（26.66%）恢复了更强的≥M4级屈肘力量。1例患者（6.25%）恢复了M2级屈肘力量，4例患者（26.66%）未恢复任何运动。我们得出结论，将两根肋间神经转移至肱二头肌运动支，在屈肘恢复方面是一种效果中等的手术方法，但它仍然是完全性臂丛神经损伤，尤其是在五根撕脱情况下少数可用的选择之一。
