Washington University School of Medicine in St. Louis, MO, USA.
Hand (N Y). 2022 Jan;17(1):NP5-NP11. doi: 10.1177/1558944721994260. Epub 2021 Mar 11.
Urgent surgical intervention for amniotic band sequence (ABS) is currently indicated for concerns of vascular compromise and progressive lymphedema. Peripheral motor nerve palsies are rare, and reports of surgical intervention in these cases describe persistent motor dysfunction. We report band release and ulnar, median, and radial nerve decompression in a 1-week-old with a severe upper extremity constriction band and signs of ulnar nerve motor dysfunction. A literature review on nerve exploration and outcomes of patients with motor nerve palsy from ABS was performed. Early evidence of ulnar motor function was observed at 5.5-month follow-up. Previous reports of nerve decompression for upper extremity constriction bands with motor nerve palsy document poor recovery after interventions beginning at 3 months of age. In this case, band release and nerve decompression were undertaken at 7 days of age, and we observed early motor recovery. This finding suggests that very early surgical intervention in the neonate may facilitate nerve recovery in appropriate candidates.
目前，对于羊膜带序列（ABS），如有血管受压和进行性淋巴水肿的风险，需要紧急手术干预。周围运动神经麻痹很少见，而这些病例的手术干预报告描述了持续的运动功能障碍。我们报告了一例 1 周大的婴儿，其上肢严重的束带和尺神经运动功能障碍，进行了束带松解和尺神经、正中神经和桡神经减压。对 ABS 引起的运动神经麻痹患者进行神经探查和结果的文献进行了回顾。在 5.5 个月的随访中观察到尺神经运动功能的早期证据。以前有报告称，上肢束带伴运动神经麻痹的神经减压术后，从 3 个月龄开始干预，恢复情况较差。在这种情况下，在 7 天大时进行了束带松解和神经减压，我们观察到了早期的运动恢复。这一发现表明，新生儿的早期手术干预可能有助于合适的患者恢复神经功能。
