Atthakomol Pichitchai, Ozkan Sezai, Chen Neal, Lee Sang-Gil
Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
BMJ Case Rep. 2019 Jul 17;12(7):e230406. doi: 10.1136/bcr-2019-230406.
The result of combined agonist and antagonist muscle innervation in traumatic brachial plexus injury through the intraplexal fascicle nerve transfers with the same donor function has not yet been reported. We describe a patient with a C5-C7 traumatic brachial plexus injury who had a combined transfer of the flexor carpi radialis (FCR) fascicle to the musculocutaneous nerve and the flexor carpi ulnaris (FCU) fascicle to the radial nerve of the triceps. The patient returned for his follow-up visit 2 years after his surgery. The muscle strengths of his triceps and biceps were Medical Research Council grade 2 and 0, respectively. Compared with his uninjured side, his grip strength was 9.8%, and his pinch strength was 14.2%. Our case report provides insights on result of combined agonist and antagonist muscle innervation through combining the motor fascicle of the FCR and FCU to restore the elbow flexor and extensor. The result may not be promising.
通过具有相同供体功能的神经束内神经移位术，对创伤性臂丛神经损伤进行联合激动剂和拮抗剂肌肉神经支配的结果尚未见报道。我们描述了一名C5-C7创伤性臂丛神经损伤患者，其接受了桡侧腕屈肌（FCR）神经束向肌皮神经的联合移位，以及尺侧腕屈肌（FCU）神经束向肱三头肌桡神经的联合移位。该患者术后2年前来复诊。其肱三头肌和肱二头肌肌力分别为医学研究委员会2级和0级。与健侧相比，其握力为9.8%，捏力为14.2%。我们的病例报告通过联合FCR和FCU的运动神经束来恢复肘屈肌和伸肌，为联合激动剂和拮抗剂肌肉神经支配的结果提供了见解。结果可能并不乐观。
