在上干后支神经丛内神经移植效果不佳后，进行肱三头肌神经至三角肌神经转移。
Triceps nerve to deltoid nerve transfer after an unsatisfactory intra-plexus neurotization of the posterior division of the upper trunk.
作者信息
Al-Qattan Mohammad M, Kattan Abdullah E, Al-Qahtany Bayan S, Al-Qattan Omar M, Al-Qattan Heba M
机构信息
Division of Plastic Surgery King Saud University, Riyadh, Saudi Arabia; Division of Plastic Surgery at National Hospital, Riyadh, Saudi Arabia.
Division of Plastic Surgery King Saud University, Riyadh, Saudi Arabia; Division of Plastic Surgery at National Hospital, Riyadh, Saudi Arabia.
出版信息
Int J Surg Case Rep. 2017;37:124-126. doi: 10.1016/j.ijscr.2017.06.026. Epub 2017 Jun 17.
INTRODUCTION
Our literature review did not reveal any study on the results of triceps to deltoid nerve transfer done as a secondary procedure after an unsatisfactory primary intraplexus neurotization of the posterior division of the upper trunk.
PRESENTATION OF CASES
We report on three adults with C5-C6 brachial plexus injury who had an unsatisfactory deltoid function following primary intraplexus neurotization. Patients presented to our clinic late (14-16 months after injury). All patients had poor shoulder abduction (<40°) despite the presence of visible and palpable deltoid contractions. A triceps to deltoid nerve transfer resulted in an excellent shoulder abduction (> 150°) in all patients.
DISCUSSION
The primary surgery in our patients acted as a "baby-sitter" procedure; explaining the good results of the late secondary distal nerve transfer.
CONCLUSION
Good results may be obtained from a late distal nerve transfer for the deltoid muscle as long as there is partial innervation of the muscle.
引言
我们的文献综述未发现有关在臂丛上干后股初次丛内神经移植效果不佳后，将肱三头肌神经转移至三角肌作为二次手术结果的任何研究。
病例介绍
我们报告了3例C5-C6臂丛神经损伤的成年患者，他们在初次丛内神经移植后三角肌功能不佳。患者很晚才到我们诊所就诊（受伤后14 - 16个月）。尽管可见且可触及三角肌收缩，但所有患者的肩部外展均较差（<40°）。将肱三头肌神经转移至三角肌后，所有患者的肩部外展均极佳（>150°）。
讨论
我们患者的初次手术起到了“保姆”手术的作用；这解释了晚期二次远端神经转移的良好效果。
结论
只要三角肌有部分神经支配，晚期对三角肌进行远端神经转移可能会取得良好效果。
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