Cooper D E, Jenkins R S, Bready L, Rockwood C A
Department of Orthopaedics, University of Texas Health Science Center, San Antonio 78284-7774.
Clin Orthop Relat Res. 1988 Mar(228):33-41.
Brachial plexus injuries that occur secondary to malposition of the patient during general anesthesia have been described in the medical literature for nearly a century. However, little can be found in the orthopedic literature. Of the peripheral nerve groups, the brachial plexus may be the most vulnerable to injury from malpositioning. This study presents three such cases of brachial plexus injury and reviews the literature concerning the subject. Pertinent anatomy, etiology, and pathogenesis of injury to the brachial plexus reveal that injury can occur from stretch or compression of nerves and is usually caused by a combination of the two. With awareness of risk factors and the positions which are likely to cause injury to the brachial plexus, careful positioning of the upper extremity can prevent injury and potential disability to the patient.
在全身麻醉期间因患者体位不当继发的臂丛神经损伤在医学文献中已有近一个世纪的描述。然而，骨科文献中对此的记载却很少。在周围神经组中，臂丛神经可能最易因体位不当而受损。本研究介绍了三例此类臂丛神经损伤病例，并回顾了有关该主题的文献。臂丛神经损伤的相关解剖结构、病因和发病机制表明，损伤可由神经拉伸或受压引起，通常是两者共同作用的结果。了解危险因素以及可能导致臂丛神经损伤的体位后，上肢的精心摆放可预防患者受伤及潜在残疾。
