Department of Orthopedics, Henan Provincial People's Hospital, No. 7, Weiwu Road, Zhengzhou, 450003, China.
Department of Microsurgery and Orthopedic Trauma, the First Affiliated Hospital of Sun Yat-Sen University, 58 Second Zhongshan Road, Guangzhou, 510080, China.
Eur J Med Res. 2021 Feb 5;26(1):17. doi: 10.1186/s40001-020-00473-8.
Ultrasonic measurement has not been utilized to assess the functional recovery of transplanted muscle. This study aimed to investigate the feasibility of using B-ultrasound measurement to assess muscle recovery following free functioning gracilis transfer.
From January 2009 to January 2014, 35 patients receiving free functioning gracilis transfer to treat total brachial plexus injury were enrolled. B-ultrasound was adopted to determine the cross-sectional area (CSA) of transplanted gracilis muscle at rest and contraction state. The ratio of pre- to post-transplant CSA value at rest state was defined as muscle bulk ratio (MBR). The ratio of CSA value at contraction state to rest state was defined as contraction ratio (CR).
Patients with muscle strength M ≥ 4 had significantly higher CR1 (post-transplant), CR2 (pre-transplant), and range of motion (ROM, joint mobility) than those with muscle strength M < 4. The CR1 > CR2 group had significantly higher CR1, muscle strength, and ROM than the CR1 ≤ CR2 group. The MBR > 1 group had significantly higher muscle strength than the MBR ≤ 1 group. CR1 value was highly correlated with muscle strength and with ROM. CR2 value was moderately correlated with muscle strength and ROM. Multivariate linear regression analysis showed that a higher CR1/CR2 value was associated with a higher muscle strength and joint mobility. The CR1 > CR2 group had better muscle strength and ROM than the CR1 ≤ CR2 groups.
B-ultrasound measurement can quantitatively reflect muscle strength following gracilis transfer, and CR value could be a potential indicator for functional recovery of the transplanted gracilis muscle.
Prognostic studies, Level II.
超声测量尚未用于评估移植肌肉的功能恢复。本研究旨在探讨使用 B 超测量评估游离股薄肌移植后肌肉恢复的可行性。
2009 年 1 月至 2014 年 1 月，共 35 例接受游离股薄肌移植治疗全臂丛神经损伤的患者入组。采用 B 超测量静息和收缩状态下移植股薄肌的横截面积（CSA）。将静息状态下移植前与移植后 CSA 值的比值定义为肌肉体积比（MBR）。将收缩状态下 CSA 值与静息状态下 CSA 值的比值定义为收缩比（CR）。
肌力 M≥4 的患者，CR1（移植后）、CR2（移植前）和关节活动度（ROM，关节活动度）明显高于肌力 M<4 的患者。CR1>CR2 组的 CR1、肌力和 ROM 明显高于 CR1≤CR2 组。MBR>1 组的肌力明显高于 MBR≤1 组。CR1 值与肌力和 ROM 高度相关。CR2 值与肌力和 ROM 中度相关。多元线性回归分析显示，较高的 CR1/CR2 值与较高的肌力和关节活动度相关。CR1>CR2 组的肌力和 ROM 明显优于 CR1≤CR2 组。
B 超测量可定量反映股薄肌移植后的肌力，CR 值可能是移植股薄肌功能恢复的潜在指标。
预后研究，II 级。
