神经移位治疗臂丛上干根性撕脱伤

目的 阐明神经移位治疗臂丛上干根性撕脱伤的疗效。方法 1990年3月至1998年2月，对14例臂丛干根性撕脱伤患者，将同侧胸前外侧神经直接移位于腑神经，胸背神经直接移位于肌皮神经，以重建三角肌、肱三头肌功能。结果 术后随访1年以上，三角肌肌力8例恢复至M4,4例M3,2例为M3－；肱二头肌肌力14例均恢复至M4。结论 运用同侧胸前外侧神经、胸背神经移闰的方法治疗臂丛上干根性撕脱伤，疗效较好；对原有的臂丛中、下干神经的主要功能无明显影响。

Nerve transfer for treatment of root avulsion of brachial plexus upper trunk

Objective To investigate the treatment outcome of nerve transfer in root avulsion injury of brachial plexus upper trunk. Methods 14 Patients with upper trunk root avulsion treated from March 1990 to February 1998 were involved. Transfer of the ipsilateral lateral pectoral nerve to the axillary nerve and thoracodorsal nerve to the musculocutaneous nerve was done to restore deltoid and biceps brachii function. The patients were followed for more than one year. Results One year postoperatively, restoration of deltoid muscle power was M 4 for 8 cases, M 3 for 4 cases, and M 3 for 2 cases. Muscle power of the biceps brachii was M 4 for all 14 cases. Conclusions Ipsilateral transfer of lateral pectoral nerve and thoracodorsal nerve leads to satisfactory outcome in treatment of root avulsion injury of brachial plexus upper trunk. No major impairment of the muscles innervated by the middle and lower trunk was found.