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运动医学中的臂丛神经损伤:临床评估、诊断方法、治疗选择及康复干预

Brachial Plexus Injuries in Sport Medicine: Clinical Evaluation, Diagnostic Approaches, Treatment Options, and Rehabilitative Interventions.

作者信息

Belviso Immacolata, Palermi Stefano, Sacco Anna Maria, Romano Veronica, Corrado Bruno, Zappia Marcello, Sirico Felice

机构信息

Department of Public Health, University of Naples "Federico II", 80131 Naples, Italy.

Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy.

出版信息

J Funct Morphol Kinesiol. 2020 Mar 30;5(2):22. doi: 10.3390/jfmk5020022.

Abstract

The brachial plexus represents a complex anatomical structure in the upper limb. This "network" of peripheral nerves permits the rearrangement of motor efferent fibers, coming from different spinal nerves, in several terminal branches directed to upper limb muscles. Moreover, afferent information coming from different cutaneous regions in upper limb are sorted in different spinal nerves through the brachial plexus. Severe brachial plexus injuries are a rare clinical condition in the general population and in sport medicine, but with dramatic consequences on the motor and sensory functions of the upper limb. In some sports, like martial arts, milder injuries of the brachial plexus can occur, with transient symptoms and with a full recovery. Clinical evaluation represents the cornerstone in the assessment of the athletes with brachial plexus injuries. Electrodiagnostic studies and imaging techniques, like magnetic resonance and high-frequency ultrasound, could be useful to localize the lesion and to define an appropriate treatment and a functional prognosis. Several conservative and surgical techniques could be applied, and multidisciplinary rehabilitative programs could be performed to guide the athlete toward the recovery of the highest functional level, according to the type of injury.

摘要

臂丛神经是上肢复杂的解剖结构。这个外周神经“网络”能使来自不同脊神经的运动传出纤维重新排列,形成多个支配上肢肌肉的终末分支。此外,来自上肢不同皮肤区域的传入信息通过臂丛神经在不同的脊神经中进行分类。严重的臂丛神经损伤在普通人群和运动医学中是一种罕见的临床情况,但会给上肢的运动和感觉功能带来严重后果。在一些运动项目中,如武术,可能会发生较轻的臂丛神经损伤,症状短暂且可完全恢复。临床评估是评估臂丛神经损伤运动员的基石。电诊断研究和成像技术,如磁共振成像和高频超声,有助于定位病变并确定合适的治疗方法和功能预后。根据损伤类型,可应用多种保守和手术技术,并实施多学科康复计划,以指导运动员恢复到最高功能水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e8a/7739249/c5b6ffda8998/jfmk-05-00022-g002.jpg

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