Coessens B C, Wood M B
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905, USA.
J Reconstr Microsurg. 1995 Jul;11(4):277-80. doi: 10.1055/s-2007-1006544.
A retrospective evaluation of the functional results after reconstructive treatment with levator scapulae transfer and scapulo-spinal fasciodesis by fascia lata slings for complete chronic trapezius palsy is presented. Five patients (ages 6 to 40 years) were operated on between 1988 and 1991 because of incapacitating pain and/or functional limitations. Treatment was recommended after failure to alleviate symptoms by a shoulder-girdle muscle-strengthening program or after unsuccessful nerve graft. The descriptions of the results are drawn from the last follow-up evaluation available for each patient (minimum: 14 months post-operative). They are expressed in terms of functional recovery, residual pain, and patient satisfaction. Three patients had an excellent result, with at least 80 percent of normal abduction and forward elevation of the arm, no residual pain, and a high satisfaction rate. One patient showed good improvement in function, with 90 percent of normal shoulder function, but complained of some residual pain. The last patient was not improved by the surgery. Levator scapulae transfer and scapulo-spinal fasciodesis by fascia lata slings, substitute for the function of the upper trapezius and enhance the function of the serratus anterior, thus helping to relieve pain and to improve shoulder function after chronic trapezius palsy. The procedure warrants consideration in patients who are not candidates for nerve repair and reconstruction.
本文对采用肩胛提肌转移术及阔筋膜条带进行肩胛-脊柱筋膜固定术重建治疗完全性慢性斜方肌麻痹后的功能结果进行了回顾性评估。1988年至1991年间，5例患者（年龄6至40岁）因疼痛难忍和/或功能受限接受了手术治疗。这些患者在通过肩带肌强化训练未能缓解症状或神经移植失败后接受了该治疗。结果描述取自每位患者的最后一次随访评估（最短：术后14个月）。结果通过功能恢复、残留疼痛及患者满意度来表示。3例患者效果极佳，手臂外展和前举至少达到正常水平的80%，无残留疼痛，满意度高。1例患者功能改善良好，肩部功能达到正常水平的90%，但仍有一些残留疼痛。最后1例患者手术效果不佳。肩胛提肌转移术及阔筋膜条带进行肩胛-脊柱筋膜固定术可替代上斜方肌的功能并增强前锯肌的功能，从而有助于缓解慢性斜方肌麻痹后的疼痛并改善肩部功能。对于不适合进行神经修复和重建的患者，该手术值得考虑。
