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《The Journal of hand surgery》2022,47(11):1121.e1-1121.e6
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Margie Wheelock Tod A Clark Jennifer L Giuffre 《CANADIAN JOURNAL OF PLASTIC SURGERY》2015,23(2):77-80
BACKGROUND:
The most common neurological defect in traumatic anterior glenohumeral dislocation is isolated axillary nerve palsy. Most recover spontaneously; however, some have persistent axillary neuropathy. An intact rotator cuff may compensate for an isolated axillary nerve injury; however, given the high rate of rotator cuff pathology with advancing age, patients with an axillary nerve injury are at risk for complete shoulder disability.OBJECTIVE:
To review reconstruction of the axillary nerve to alleviate shoulder pain, augment shoulder stability, abduction and external rotation to alleviate sole reliance on the rotator cuff to move and stabilize the shoulder.METHODS:
A retrospective review of 10 patients with an isolated axillary nerve injury and an intact rotator cuff who underwent a triceps nerve branch to axillary nerve transfer was performed. Patient demographics, surgical technique, deltoid strength, donor-site morbidity, complications and time to surgery were evaluated.RESULTS:
Ten male patients, mean age 38.3 years (range 18 to 66 years), underwent a triceps to axillary nerve transfer for isolated axillary nerve injury 7.4 months (range five to 12 months) post-traumatic shoulder dislocation. Deltoid function was British Medical Research Council grade 0/5 in all patients preoperatively and ≥3/5 deltoid strength in eight patients at final follow-up (14.8 months [range 12 to 25 months]). There were no complications and no donor-site morbidity.CONCLUSION:
A triceps to axillary nerve transfer for isolated axillary neuropathy following traumatic shoulder dislocation improved shoulder pain, stability and deltoid strength, and potentially preserves shoulder function with advancing age by alleviating sole reliance on the rotator cuff for shoulder abduction and external rotation. 相似文献14.
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目的:了解桡神经浅支卡压的依据并讨论了该征的诊断及治疗原则。方法:解剖观测了20具40侧成人上肢标本桡神经浅支穿出处的局部解剖特点及其距桡骨茎突的距离,随访了12例患者,9例采用局部封闭治疗,3例采用手术神经松解治疗。结果:桡神经浅支穿出部位为腱性组织所包绕。该处筋膜将肱桡肌腱挤在一起,从而易于受压。临床随访6个月至2年,保守及手术治疗患者症状均完全消失无复发。结论:解剖:桡神经浅支在前臂中下段易发生卡压有其解剖学基础。临床上病程短症状轻患者保守治疗往往能有较好疗效,病程长症状重或存在其它病理性压迫患者往往需要手术治疗。 相似文献
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