Gu Y D, Chen D S, Zhang G M, Cheng X M, Xu J G, Zhang L Y, Cai P Q, Chen L
Department of Hand Surgery, Shanghai Medical University, China.
J Reconstr Microsurg. 1998 Jan;14(1):57-9. doi: 10.1055/s-2007-1006902.
From 1986 to 1994, 82 patients with brachial plexus root avulsion were operated on using a contralateral C7 nerve-root transfer. Forty-four patients underwent a one-stage procedure in which the distal end of the ulnar nerve was anastomosed to the contralateral C7 root, and the other 38 underwent a two-stage procedure (first phase: C7 root --> ulnar nerve; second phase: ulnar nerve --> recipient nerve). Twenty postoperative cases were followed-up for 2 years. Of them, the ulnar nerve was transferred to the musculocutaneous nerve in six cases, with recovery of the biceps up to M3 in four and S3 in five cases; the ulnar nerve was transferred to the median nerve in eight cases, with recovery of the wrist and finger flexors up to M3 in five and S3 in six cases; the ulnar nerve was transferred to the radial nerve in four cases, with recovery of the triceps up to M4 in two and S3 in three cases; and the ulnar nerve was transferred to the thoracodorsal nerve in two cases, with recovery of the latissimus dorsi to M4 in one case. The total muscle recovery rate (up to M3) of the series was 60 percent, and the sensory recovery rate (S3) was 78 percent. Outcomes were related to patient age, operative delay, and whether or not the ulnar nerve was used as a bridge for transfer.
1986年至1994年，82例臂丛神经根撕脱患者接受了对侧C7神经根移位手术。44例患者接受一期手术，将尺神经远端与对侧C7神经根吻合，另外38例接受二期手术（第一阶段：C7神经根→尺神经；第二阶段：尺神经→受区神经）。20例术后患者进行了2年随访。其中，6例尺神经移位至肌皮神经，4例肱二头肌恢复至M3级，5例恢复至S3级；8例尺神经移位至正中神经，5例腕和手指屈肌恢复至M3级，6例恢复至S3级；4例尺神经移位至桡神经，2例肱三头肌恢复至M4级，3例恢复至S3级；2例尺神经移位至胸背神经，1例背阔肌恢复至M4级。该组总的肌肉恢复率（达M3级）为60%，感觉恢复率（S3级）为78%。结果与患者年龄、手术延迟以及是否使用尺神经作为移位桥梁有关。
