完全性产瘫中C8-T1神经根原位部分撕脱伴瘢痕形成。
Scarring of the C8-T1 roots with partial avulsion in situ in total obstetric brachial plexus palsy.
作者信息
Al-Qattan Mohammad M, El-Sayed Amel A F
机构信息
Department of Surgery, King Saud University, P.O. Box 18097, Riyadh, 11415 Saudi Arabia.
Department of Obstetrics and Gynecology, King Saud University, Riyadh, Saudi Arabia.
出版信息
Eur J Plast Surg. 2017;40(5):465-470. doi: 10.1007/s00238-017-1281-3. Epub 2017 Feb 17.
BACKGROUND
Primary exploration of the brachial plexus in infants with obstetric palsy may reveal scarring of the lower roots with evidence of partial avulsion-in-situ. As we have been treating this lesion by neurolysis only, we aimed to investigate the recovery of hand function following such approach.
METHODS
A series of 14 cases of total obstetric palsy with with evidence of partial avulsion-in-situ of the lower roots were included. All lesions were treated by neurolysis only (with no neurotization of the lower roots). Management of the injured upper roots was done by neurotization. Recovery was assessed as per our motor grading system.
RESULTS
After a minimum follow-up of 4 years, hand functional recovery was considered good in 7 patients and excellent in the remaining 7 patients.
CONCLUSIONS
We highlight the scarring of lower roots with evidence of partial avulsion-in situ in obstetric palsy. We also document that neurolysis is an acceptable approach to such lesions. Level of Evidence: Level IV, therapeutic study.
背景
对产瘫婴儿的臂丛神经进行初次探查时，可能会发现下神经根存在瘢痕形成并有部分原位撕脱的迹象。由于我们一直仅通过神经松解术来治疗这种损伤，因此我们旨在研究采用这种方法后手功能的恢复情况。
方法
纳入了一系列14例完全性产瘫且有下神经根部分原位撕脱迹象的病例。所有损伤均仅通过神经松解术进行治疗（未对下神经根进行神经移植）。对受损上神经根的处理采用神经移植。根据我们的运动分级系统评估恢复情况。
结果
在至少随访4年后，7例患者的手功能恢复情况被认为良好，其余7例患者恢复情况极佳。
结论
我们强调了产瘫中下神经根存在瘢痕形成并有部分原位撕脱的迹象。我们还记录了神经松解术是治疗此类损伤的一种可接受的方法。证据级别：IV级，治疗性研究。
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