Beauchamp M, Beaton D E, Barnhill T A, Mackay M, Richards R R
Upper Extremity Reconstructive Service, St. Michael's Hospital and the University of Toronto, Ontario, Canada.
J Shoulder Elbow Surg. 1998 Mar-Apr;7(2):90-6. doi: 10.1016/s1058-2746(98)90216-6.
A study was undertaken to assess functional outcome in 11 patients undergoing latissimus dorsi and teres major transfer (L'Episcopo procedure) for external rotation deficient shoulders. The mean age was 37 years (range 18 to 48 years). All of the patients had adult-onset brachial plexus injuries. The mean time for injury to operation was 32 months. Patients were evaluated by questionnaire, measurement of the range of motion, strength testing, and an overhead work simulation. Of the patients studied, 10 of the 11 patients were working (8 returned to their preinjury employment). The cumulative postoperative mean activities of daily living score was 20 (maximum possible 33) compared with 14 before surgery. No complications occurred. Ten patients reported confidence in the limb and believed the procedure was worthwhile. Mean active external rotation of the shoulder at 0 degrees and 90 degrees elevation was 28 degrees (range 15 degrees to 55 degrees and 36 degrees (range 0 degrees to 90 degrees), respectively. Postoperative external rotation strength was 0.32 that of the control side with the arm at the side. Seven of the nine patients tested were able to complete the Valpor overhead work simulation. The L'Episcopo muscle-tendon transfer reliably improves functional outcome in the late functional reconstruction of adult-onset brachial plexus lesions.
一项研究旨在评估11例因外旋功能不足而接受背阔肌和大圆肌转移术（L'Episcopo手术）的患者的功能结局。平均年龄为37岁（范围18至48岁）。所有患者均为成人期臂丛神经损伤。受伤至手术的平均时间为32个月。通过问卷调查、活动范围测量、力量测试和模拟上肢工作对患者进行评估。在研究的患者中，11例中有10例在工作（8例恢复了受伤前的工作）。术后日常生活活动累计平均得分20分（满分33分），术前为14分。未发生并发症。10例患者对患侧肢体有信心，认为该手术值得。肩部在0度和90度抬高时的平均主动外旋分别为28度（范围15度至55度）和36度（范围0度至90度）。术后手臂在体侧时的外旋力量为对照侧的0.32倍。接受测试的9例患者中有7例能够完成Valpor模拟上肢工作。L'Episcopo肌腱转移术在成人期臂丛神经损伤的晚期功能重建中能可靠地改善功能结局。
