Upper Extremity and Reconstructive Microsurgery Unit, Institute of Orthopaedics, Lerdsin Hospital, Department of Orthopaedic Surgery, College of Medicine, Rangsit University, Bangkok, Thailand.
Orthopaedic Oncology Unit, Institute of Orthopaedics, Lerdsin Hospital, Department of Orthopaedic Surgery, College of Medicine, Rangsit University, Bangkok, Thailand.
J Hand Surg Am. 2023 Nov;48(11):1168.e1-1168.e6. doi: 10.1016/j.jhsa.2022.04.022. Epub 2022 Jul 6.
The aim of this study was to evaluate the function of the posterior part of the deltoid after nerve transfer of the long head triceps branch of the radial nerve to the anterior branch of the axillary nerve in patients with an upper brachial plexus injury or isolated axillary nerve injury.
We retrospectively reviewed 26 patients diagnosed with an upper brachial plexus injury or isolated axillary nerve injury who underwent nerve transfer of the long head triceps muscle branch of the radial nerve to the anterior branch of the axillary nerve in our institute between 2012 and 2017. Data on age, sex, the mechanism of injury, the pattern of injury, and operative treatment were collected from medical records. Preoperative and postoperative clinical examinations, including motor powers of shoulder abduction and extension according to Medical Research Council grading, were evaluated. At a minimum of 2 years after the operation, we evaluated the recovery of the posterior deltoid function using the swallow-tail test.
Twenty-two patients (84.6%) had recovery of posterior deltoid function confirmed by the swallow-tail test. There were 23 patients (88.5%) who achieved at least Medical Research Council grade 4 of shoulder abduction.
Nerve transfer from the branch to the long head triceps to the anterior branch of the axillary nerve is an effective technique for restoring deltoid function in an upper brachial plexus injury or isolated axillary nerve injury. This technique can provide shoulder abduction and shoulder extension, which are the functions of the posterior deltoid muscle.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
本研究旨在评估桡神经长头肱三头肌支神经转移至腋神经前支后三角肌后部的功能，用于治疗上臂丛神经损伤或孤立性腋神经损伤的患者。
我们回顾性分析了 2012 年至 2017 年期间在我院接受桡神经长头肱三头肌支神经转移至腋神经前支手术的 26 例上臂丛神经损伤或孤立性腋神经损伤患者的临床资料。从病历中收集了年龄、性别、损伤机制、损伤类型和手术治疗等数据。对术前和术后的临床检查，包括根据医学研究委员会分级的肩外展和外展肌力进行评估。术后至少 2 年，我们使用燕尾试验评估三角肌后部功能的恢复情况。
22 例患者（84.6%）通过燕尾试验证实三角肌后部功能恢复。23 例患者（88.5%）达到至少医学研究委员会 4 级肩外展。
从桡神经长头肱三头肌支到腋神经前支的神经转移是一种恢复上臂丛神经损伤或孤立性腋神经损伤三角肌功能的有效技术。该技术可以提供三角肌后部的肩外展和肩外展功能。
研究类型/证据水平：治疗性 IV 级。
