背阔肌皮瓣移位重建屈肘功能12例

自１９９１年３月￣１９９３年１０月，利用背阔肌移位重建臂丛神经损伤的屈肘功能１２例，随访６个月￣２年半，疗效满意。优点为：①不可逆性臂丛神经损伤肢体多为“皮包骨”，采用肌皮瓣移位，增大了肢体周径，减少了皮肤张力，有利于移位后肌肉滑行，改善了外观，同时也便于术后血运观察。②部分臂丛根性损伤，背阔肌多已萎缩无功能，利用神经移位重建胸背神经而恢复的背阔肌功能，再移位重建屈肘功能，证明是有效可行的。分析讨

ABSTRACTTHE LAIISSIMUS DORSI MUSCULOCUTANEOUS FLAP FOR RECONSTRUCTION OFFLEXOR OF ELBOW

rom March 1991 to October 1993,6 the latissimus dorsi M, was transferred to reconstructthe flexor of the elbow following the injury of brachial plexus in 12 cases(8 males and 4femaies).The average age was 31-year-old(6to 45-year-old).The patients were followed up forsix months to two years.All of musculocutaneous flaps were survived. The contour of the upperarm was satisfactory. In 8 cases,the muscle strength was more than grade 4 and the active mo-tion of the elbow was l35 degrees in flexion and 10 degrees in extension.The elbow could lift theload of 10kg.In 2 cases,the muscle strength was grade 4 and the active movement was 25 de-grees in flexion and 25 degrees in extension. On 90 degrees flexion,the elbow could lift the loadof 3kg.In 2 cases,the muscle strength was grade 3 and the active movement of elbow was 100degrees in flexion 25 degrees in extension. Following the irreversible injury of the brachialplexlls,the atrophy of the muscles was obvious.After the transfer of musculocutaneous flap, thecircumference of the arm was increased while the tenseness of the sk in was decreased,This facili-ated the movement of the transferred muscle,improved the appearance of the upper limb and wasconvenient to observe the blood supply of the flap.When the brachial plexus was injuried at theroot level,the latissimus dorsi M.was atrophied,after transfer of the nerve to the muscle,thefunction of the muscle recovered,then the tranferred muscle could be transferred to reconstructthe flexor of the elbow.