选择性肌支神经转位治疗臂丛上干损伤

目的 选择最好的肌支神经转位治疗臂丛上干损伤。方法 采用选择性肌支神经转位治疗臂丛上干损伤１６例２４人次，供转位的胸背神经，副神经，胸长神经和肋间神经等与腋神经的三角肌支，肌皮神经的肱二头肌支缝接。结论 手术的关键是肌支神经与肌支神经的缝接，从而使吻合口靠近肌肉，关节功能恢复快，转位神经中以胸背神经转位效果最好。

Transference of selected muscular branchial nerve for treatment of upper trunk injury of brachial plexus

Objective To analyse the outcomes of transference of the best selected muscular branchial nerve for treatment of upper trunk injury of brachial plexus. Methods 16 patients(24 persontimes) who suffered from upper trunk injury of brachial plexus were treated with transference of selected nerve of muscular branch. The thoracodorsal nerve, accessory nerve, long thoracic nerve and intercostal nerves were transferred to the muscular branch of axillary nerve and musculocutaneous nerve. Results 24 muscles in 16 patients were followed up for 4 to 11 years after operation. The outcomes were excellent in 12, good in 5, fair in 4, and failed in 3 of 24 muscles. Conclusion The key to the operation is transferring the muscular branch to muscular branch of the associated nerve. The thoracodorsal nerve is the best one for transference.