Yang Xun, Liu Yuzhou, Zhao Xin, Lao Jie
Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China; Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, People's Republic of China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, People's Republic of China.
Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China; Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, People's Republic of China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, People's Republic of China.
J Electromyogr Kinesiol. 2018 Dec;43:158-161. doi: 10.1016/j.jelekin.2018.10.002. Epub 2018 Oct 8.
In this study, we investigated the electrophysiologic recovery of the abductor pollicis brevis (APB) muscle after contralateral seventh cervical (cC7) nerve transfer for the treatment of global brachial plexus avulsion (GBPA). We retrospectively analyzed the electromyography records of 95 patients with GBPA, comprising 81 men and 14 women, focusing on the motor unit potential (MUP) recovery of the APB. All patients underwent cC7-median nerve (MN) transfer. The cC7 nerve was transferred to the MN alone in 58 patients (One-Nerve Group), whereas 37 patients underwent cC7 transfer to the MN and another nerve (Two-Nerve Group). Fifty-three patients (MUP Group) exhibited MUP recovery of the APB, whereas 42 patients did not (No-MUP Group). The MUP Group comprised 32 patients from the One-Nerve Group and 21 patients from the Two-Nerve Group. The mean age of the MUP Group was significantly lower than that of the No-MUP Group. In summary, electrophysiologic recovery of the APB was common in patients with GBPA after cC7-MN transfer, indicating that it may be possible to restore the function of the intrinsic muscles of the hand after GBPA. The rehabilitation strategy for patients with GBPA, which overlooks the restoration of intrinsic hand muscle function, may require amendment.
在本研究中，我们调查了在对侧第七颈神经（cC7）转移治疗全臂丛神经撕脱伤（GBPA）后，拇短展肌（APB）的电生理恢复情况。我们回顾性分析了95例GBPA患者的肌电图记录，其中包括81名男性和14名女性，重点关注APB的运动单位电位（MUP）恢复情况。所有患者均接受了cC7-正中神经（MN）转移。58例患者（单神经组）仅将cC7神经转移至MN，而37例患者将cC7转移至MN及另一神经（双神经组）。53例患者（MUP组）APB出现MUP恢复，而42例患者未出现（无MUP组）。MUP组包括单神经组的32例患者和双神经组的21例患者。MUP组的平均年龄显著低于无MUP组。总之，cC7-MN转移后GBPA患者中APB电生理恢复较为常见，这表明GBPA后可能恢复手部内在肌功能。忽视手部内在肌功能恢复的GBPA患者康复策略可能需要修正。
