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背阔肌肌皮瓣双极移位修复晚期创伤性臂丛神经损伤所致肘关节屈曲功能:13例病例评估

Bipolar Transfer of Latissimus Dorsi Myocutaneous Flap for Restoration of Elbow Flexion in Late Traumatic Brachial Plexus Injury: Evaluation of 13 Cases.

作者信息

Azab Ahmed Abo-Hashem, Alsabbahi Mohammad Salah

机构信息

From the Plastic and Reconstructive Surgery Department, Faculty of Medicine, Zagazig University, Ismailia, Egypt.

出版信息

Ann Plast Surg. 2017 Feb;78(2):198-201. doi: 10.1097/SAP.0000000000000907.

Abstract

BACKGROUND

Restoration of elbow flexion following traumatic brachial plexus injury represents a great challenge to the reconstructive surgeons. Functional muscle transfers come next to the sophisticated types of nerve surgery in this area. Many transfers are well known for restoration of elbow flexion; bipolar or unipolar latissimus dorsi, triceps brachii, sternocleidomastoid, pectoralis major, and Steindler flexorplasty.

OBJECTIVE

Evaluation of the outcome of bipolar transfer of latissimus dorsi myocutaneous flap when used to restore elbow flexion in late traumatic brachial plexus injury.

PATIENTS AND METHODS

Thirteen patients were included in this case series with careful evaluation both preoperatively and postoperatively both clinically and using electromyography.

RESULTS

Almost 84.6% of patients (11 of 13) developed G3-4 on the Medical Research Council grading with relatively minimal both donor-site and recipient-site morbidity.

CONCLUSIONS

Bipolar transfer of latissimus dorsi myocutaneous flap is a reliable method for restoration of elbow flexion in patients suffering from late sequelae of traumatic brachial plexus injury.

摘要

背景

创伤性臂丛神经损伤后恢复肘关节屈曲功能对重建外科医生来说是一项巨大挑战。在该领域,功能性肌肉转移仅次于复杂的神经外科手术类型。许多转移方法因可恢复肘关节屈曲功能而广为人知,如双极或单极背阔肌、肱三头肌、胸锁乳突肌、胸大肌以及施泰德勒屈肌成形术。

目的

评估背阔肌肌皮瓣双极转移用于恢复晚期创伤性臂丛神经损伤患者肘关节屈曲功能的效果。

患者与方法

本病例系列纳入了13例患者,并在术前和术后进行了仔细的临床评估及肌电图检查。

结果

几乎84.6%的患者(13例中的11例)在医学研究委员会分级中达到G3 - 4级,供区和受区的并发症相对较少。

结论

背阔肌肌皮瓣双极转移是恢复创伤性臂丛神经损伤晚期后遗症患者肘关节屈曲功能的可靠方法。

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