Weinzweig N, Barr A
Department of Orthopedic Surgery, University of Illinois at Chicago.
Plast Reconstr Surg. 1994 Nov;94(6):872-6. doi: 10.1097/00006534-199411000-00022.
Single-stage correction of a congenital constriction band of the arm in an infant with radial, ulnar, and median nerve dysfunction is reported with significant improvement in neurologic function. This was accomplished by thorough preoperative physical examination and neurologic evaluation, circumferential excision of the constricting band, decompression of the involved peripheral nerves, and multiple large Z-plasties for skin closure. Based on the case presented here and a review of the literature, management of patients with congenital constriction rings overlying major nerve trunks should include (1) complete neurologic examination, even in the infant, (2) electromyographic and nerve conduction studies if there is any evidence of nerve dysfunction, (3) early complete excision of the band in one stage if there is no evidence of edema seen with lymphatic or venous obstruction (otherwise, two-stage removal of the band should be planned), and (4) early exploration and decompression of all major peripheral nerves beneath the band if there is any neurologic dysfunction.
报告了一名患有桡神经、尺神经和正中神经功能障碍的婴儿手臂先天性束带的单阶段矫正，神经功能有显著改善。这是通过术前全面的体格检查和神经评估、束带的环形切除、受累周围神经的减压以及多个大型Z形皮瓣用于皮肤闭合来实现的。基于本文介绍的病例和文献回顾，对于覆盖主要神经干的先天性束带患者的处理应包括：（1）即使是婴儿也应进行全面的神经检查；（2）如果有任何神经功能障碍的证据，应进行肌电图和神经传导研究；（3）如果没有淋巴管或静脉阻塞导致水肿的证据，应早期一次性完全切除束带（否则，应计划分两阶段切除束带）；（4）如果有任何神经功能障碍，应早期探查并减压束带下方的所有主要周围神经。
