Yang Yi, Yang Jian-Tao, Fu Guo, Li Xiang-Ming, Qin Ben-Gang, Hou Yi, Qi Jian, Li Ping, Liu Xiao-Lin, Gu Li-Qiang
Department of Microsurgery and Orthopedic Trauma, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
Department of Orthopedic Surgery, the First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471003, China.
Sci Rep. 2016 Mar 3;6:22479. doi: 10.1038/srep22479.
In the study, the functional recovery and relative comprehensive quality of life of cases of global brachial plexus treated with free functioning muscle transfers were investigated. Patients who received functioning gracilis muscle transfer between August 1999 and October 2014 to reconstruct elbow flexion, wrist and fingers extension were recruited. The mean age of the patients was 26.36 (range, 16-42) years. The mean period of time from gracilis transfer to the last follow-up was 54.5 months (range, 12-185 months). Muscle power, active range of motion of the elbow flexion, wrist extension, and total active fingers extension were recorded. SDS, SAS and DASH questionnaires were given to estimate patients' quality of life. 35.71% reported good elbow flexion and 50.00% reported excellent elbow flexion. The average ROM of the elbow flexion was 106.5° (range, 0-142°) and was 17.00° (range, 0-72°) for wrist extension. The average DASH score was 51.14 (range, 17.5-90.8). The prevalence of anxiety and depression were 42.86% and 45.24%. Thrombosis and bowstringing were the most common short and long-term complications. Based on these findings, free gracilis transfer using accessory nerve as donor nerve is a satisfactory treatment to reconstruct the elbow flexion and wrist extension in global-brachial-plexus-injured patients.
在这项研究中，对采用游离功能性肌肉移植治疗全臂丛神经损伤病例的功能恢复情况及相对综合生活质量进行了调查。招募了1999年8月至2014年10月期间接受股薄肌功能性移植以重建屈肘、伸腕和伸指功能的患者。患者的平均年龄为26.36岁（范围16 - 42岁）。从股薄肌移植到最后一次随访的平均时间为54.5个月（范围12 - 185个月）。记录了肌肉力量、屈肘、伸腕以及手指总主动伸展的活动范围。采用SDS、SAS和DASH问卷评估患者的生活质量。35.71%的患者报告屈肘功能良好，50.00%的患者报告屈肘功能优秀。屈肘的平均活动范围为106.5°（范围0 - 142°），伸腕的平均活动范围为17.00°（范围0 - 72°）。DASH平均评分为51.14（范围17.5 - 90.8）。焦虑和抑郁的患病率分别为42.86%和45.24%。血栓形成和弓弦状畸形是最常见的近期和远期并发症。基于这些发现，以副神经为供体神经的游离股薄肌移植是重建全臂丛神经损伤患者屈肘和伸腕功能的一种令人满意的治疗方法。
