Agarwal Pawan, Kukrele Rajeev, Sharma Dhananjaya
Charge Plastic Surgery Unit, Department of Surgery NSCB Government Medical College, Jabalpur, MP, 482003, India.
Department of Surgery NSCB Government Medical College, Jabalpur, MP, 482003, India.
J Clin Orthop Trauma. 2020 Jul-Aug;11(4):630-636. doi: 10.1016/j.jcot.2020.05.012. Epub 2020 May 18.
-Loss of radial nerve function leads to severe weakness of grip and tendon transfer is considered the standard treatment. However; there is continuing debate as to the best combination of tendon transfers in such patients. The aim of this study is to present the results of Flexor carpi radialis (FCR) combination of triple tendon transfer for radial nerve palsy.
It is a retrospective study conducted over 15 years. 58 patients of with irreversible radial nerve paralysis were included. Brands transfer was performed in all cases. The ranges of movement of the wrist, fingers and thumb were evaluated pre-operatively and postoperatively using Bincaz scale.
Total 58 patients were included in the study, 47 were male and 11 female patients with mean age of 35.27 years. Causes of radial nerve palsy were comminuted open humeral fracture (n = 42), penetrating injuries (n = 13) and brachial plexus palsy (n = 3). Mean duration of palsy was 9.37 months (range = 9-12 months). The mean post-operative follow-up was 10 (range = 2-15) years. On evaluation with the Bincaz score, 6 patients had excellent results, 49 patients had good results, and 3 patients had poor results. There were 3 complications in 5 patients, including radial deviation of wrist, inadequate abduction of thumb and restricted wrist flexion. 55 patients (94.82%) were able to return to their normal daily work after ∼8 weeks. Tendon transfer is a standard procedure for radial nerve palsy but potential advantage of one method over the other has not been demonstrated. Brand's transfer results in an acceptable restoration of hand function.
桡神经功能丧失会导致严重的握力减弱，肌腱转位被认为是标准治疗方法。然而，对于此类患者肌腱转位的最佳组合方式仍存在持续的争论。本研究的目的是展示桡侧腕屈肌（FCR）三联肌腱转位治疗桡神经麻痹的结果。
这是一项为期15年的回顾性研究。纳入了58例不可逆性桡神经麻痹患者。所有病例均进行了布兰德（Brands）转位。术前和术后使用宾卡兹（Bincaz）量表评估腕关节、手指和拇指的活动范围。
本研究共纳入58例患者，其中男性47例，女性11例，平均年龄35.27岁。桡神经麻痹的原因包括肱骨粉碎性开放性骨折（n = 42）、穿透伤（n = 13）和臂丛神经麻痹（n = 3）。麻痹的平均持续时间为9.37个月（范围为9 - 12个月）。术后平均随访时间为10年（范围为2 - 15年）。根据宾卡兹评分评估，6例患者结果优秀，49例患者结果良好，3例患者结果不佳。5例患者出现3种并发症，包括腕关节桡偏、拇指外展不足和腕关节屈曲受限。55例患者（94.82%）在约8周后能够恢复正常日常工作。肌腱转位是桡神经麻痹的标准手术方法，但尚未证明一种方法相对于另一种方法的潜在优势。布兰德转位可使手部功能得到可接受的恢复。
