正中神经、尺神经部分束支移位术重建屈肘功能的远期疗效分析

目的 观察正中神经、尺神经部分束支移位重建屈肘功能的远期疗效，总结其手术适应证的影响疗效的因素。方法 对36例患者进行平均为29．2个月的长期随访，按结果评定手术疗效并分析影响疗效的主要因素。结果 手术有效率达94．4％，优良率达63．9％。影响手术疗效的6个主要因素为：损伤类型、受伤原因、手术距受伤时间、患者年龄、供体神经的选择及术后功能锻炼。准确判断患者的损伤类型，严格掌握手术适应证是手术成功的关键。结论 正中神经、尺神经部分束支移位术是治疗臂丛神经上干型根性撕脱伤的一种安全、可靠而有效的手术方法。

Transfer of partial fascicles of median nerve or ulnar nerve for restoration of elbow flexion: analysis of long-term result

Objective　To evaluate the long - term results of median or ulnar nerve partial fascicle transfer for restoration of elbow flexion, and summarize the surgical indications and influencing factors. Methods　Thirty - six patients with elbow flexion impariment due to brachial plexus injury underwent nerve transfer using a part of median and ulnar nerve to the motor branch of the biceps muscle. Follow - up period ranged from 6 months to 65 months (average 29.2 months). Results　Twenty - three patients had M4 biceps strength and more than 90° elbow flexion. Eleven patients had M3 biceps strength and 60° ～ 90° elbow flexion. Only 2 patients had poor result. The effective rate was 94.4 %, while the excellent and good rate was 63.9 %. The type and cause of injury, post traumatic interval, donor nerve, patients'age, and rehabilitation were the major factors influencing the treatment outcome.Conclusions　Median or ulnar nerve partial fascicle transfer was an effective procedure for elbow flexion reconstruction in C5,6 or C5,6,7 avulsion of the brachial plexus.