Potter Shirley M, Ferris Scott I
Victorian Plastic Surgery Unit, St Vincent's Private Hospital, Melbourne, VIC, Australia; The Alfred Hospital, Melbourne, VIC, Australia.
Front Surg. 2016 Mar 14;3:17. doi: 10.3389/fsurg.2016.00017. eCollection 2016.
We describe the clinical outcome of a novel nerve transfer to restore active shoulder motion in upper brachial plexus injury. The thoracodorsal nerve (TDN) was successfully used as a vascularized donor nerve to neurotize to the suprascapular nerve (SSN) in a patient with limited donor nerve availability. At 4 years follow-up, he had regained useful external rotation of the injured limb, with no significant donor site morbidity. Shoulder abduction return was less impressive, however, and reasons for this are discussed. We provide a comprehensive review of the literature on this topic and a subsequent discussion on the details of this novel technique. This is the first reported case of TDN to SSN transfer, and also the first reported case of a vascularized TDN transfer in the English language literature. We advocate direct thoracodorsal to SSN transfer as a valid surgical option for the restoration of shoulder function in patients with partial brachial plexus avulsion, when conventional nerve donors are unavailable.
我们描述了一种新型神经移位术的临床结果，该手术用于恢复上臂丛神经损伤后的肩部主动活动。在供体神经有限的一名患者中，胸背神经（TDN）成功用作带血管的供体神经，与肩胛上神经（SSN）进行神经吻合。随访4年时，患者受伤肢体已恢复了有用的外旋功能，供体部位无明显并发症。然而，肩部外展功能的恢复不太理想，对此原因进行了讨论。我们对该主题的文献进行了全面综述，并随后讨论了这种新技术的细节。这是首例报道的TDN至SSN移位术，也是英文文献中首例报道的带血管TDN移位术。我们主张，当传统神经供体不可用时，直接将胸背神经移位至肩胛上神经作为恢复部分臂丛神经撕脱伤患者肩部功能的一种有效手术选择。
