Viswamadesh Ramachandran, Rajendiran Subashini, Pakiri Maheswaran Arvind Maharaj, Gomathinayagam Karthikeyan
Plastic and Reconstructive Surgery, Cancer Institute Adayar, Chennai, IND.
Hand Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Cureus. 2022 Jun 3;14(6):e25626. doi: 10.7759/cureus.25626. eCollection 2022 Jun.
Background and objective Brachial plexus injuries more commonly affect the younger generation who constitute the productive workforce. The patients who sustain avulsion injuries of the brachial plexus are more often involved in high-velocity accidents. The avulsion injuries are surgically managed by nerve transfers. This study aimed to evaluate the demography of brachial plexus avulsion injuries. Materials and methods This retrospective study was conducted in January 2013 and included 21 patients treated from January 2007 to December 2011. Results Of the 21 patients, 20 were male and the most commonly affected patients were in the age group of 21-30 years. The mean age of the affected patients was 27.24 years. Six of the patients had pan palsy (C5-8 and T1), nine had C5-7 injury, and six had C5-6 injury. Twenty patients underwent spinal accessory to suprascapular nerve transfer, nine patients underwent ulnar nerve fascicle to nerve to biceps branch transfer, and one patient underwent intercostal nerve to musculocutaneous nerve transfer. Of note, 40% of the patients regained more than M3 power for abduction and external rotation of the shoulder, and 30% of the patients regained more than M3 power for elbow function. Conclusions Road traffic accidents are the most common cause of brachial plexus injuries. Nerve transfers for shoulder and elbow function play a significant role in improving the function of the upper extremity.
背景与目的 臂丛神经损伤更常影响构成劳动力主体的年轻一代。遭受臂丛神经撕脱伤的患者更多地卷入高速事故中。撕脱伤通过神经移植进行手术治疗。本研究旨在评估臂丛神经撕脱伤的人口统计学特征。材料与方法 这项回顾性研究于2013年1月进行,纳入了2007年1月至2011年12月期间接受治疗的21例患者。结果 在这21例患者中,20例为男性,最常受影响的患者年龄在21 - 30岁组。受影响患者的平均年龄为27.24岁。6例患者为全瘫(C5 - 8和T1),9例为C5 - 7损伤,6例为C5 - 6损伤。20例患者接受了副神经至肩胛上神经移植,9例患者接受了尺神经束至肱二头肌分支神经移植,1例患者接受了肋间神经至肌皮神经移植。值得注意的是,40%的患者在肩部外展和外旋时恢复了超过M3级的肌力,30%的患者在肘部功能方面恢复了超过M3级的肌力。结论 道路交通事故是臂丛神经损伤最常见的原因。针对肩部和肘部功能的神经移植在改善上肢功能方面发挥着重要作用。