Rutowski R
Clinic for Surgical Traumatology, Medical Academy in Wroclaw, Poland.
Microsurgery. 1993;14(4):285-8. doi: 10.1002/micr.1920140414.
In the years 1982-1991, we treated over 100 patients with avulsion of from one to five roots in perinatal (n = 21) and traumatic (n = 81) lesions of the brachial plexus. Based on the clinical diagnosis and the surgical findings, we divided all operated patients into four groups: 1) avulsion of all roots or avulsions and disruption of the rest of the brachial plexus; 2) avulsion and disruption of one to four roots and preservation of some elements of the brachial plexus with fibrotic changes; 3) avulsion and disruption of one to three roots, with some elements showing no macroscopic changes; and 4) children with perinatal brachial plexus palsy. In cases of root avulsion, we performed neurotization from the cervical plexus, the accessory and intercostal nerves. In patients with one to three root avulsions, we have performed selective neurotization for 3 years. The best results were obtained in groups 3 and 4, but some improvement was also noted in the other groups.
在1982年至1991年期间,我们治疗了100多名臂丛神经围产期(n = 21)和创伤性(n = 81)损伤导致一至五根神经根撕脱的患者。根据临床诊断和手术结果,我们将所有接受手术的患者分为四组:1)所有神经根撕脱或神经根撕脱合并臂丛神经其他部分中断;2)一至四根神经根撕脱并伴有臂丛神经部分纤维性改变;3)一至三根神经根撕脱,部分神经无肉眼可见变化;4)围产期臂丛神经麻痹患儿。对于神经根撕脱的病例,我们采用颈丛、副神经和肋间神经进行神经移植。对于一至三根神经根撕脱的患者,我们进行了3年的选择性神经移植。第3组和第4组取得了最佳效果,但其他组也有一定改善。