桡神经肱三头肌长头支修复腋神经瘫的临床应用(英文)  

Clinical application of the branch to the long head of triceps brachii from radial nerve in the restoration of axillary nerve paralysis

作　　者：侯之启[1] 徐中和[1] 

机构地区：[1]广州医学院附属第一人民医院骨科,广东省广州市510180

出　　处：《中国临床康复》2004年第20期4114-4115,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:腋神经损伤临床较为常见,治疗方法不尽一致,效果也各不相同,多要牺牲相邻一条神经功能来进行神经修复。目的:介绍用肱三头肌长头支转位修复腋神经的解剖学特点和临床应用效果。设计:以神经干走行方向纵向观察研究。地点和对象:资料收集于广州医学院附属市一人民医院,采用灌注成人尸体标本16具及本院收治的6例患者。方法:采用灌注成人尸体标本16具,常规解剖显露腋神经和肱三头肌长头支,主要观察腋神经和桡神经肱三头肌支的分支数量、毗邻关系以及测量各神经支的口径。根据解剖学特点,前瞻性地应用于临床6例,术后进行随访,定期检查腋神经肌力。主要观察指标:解剖观察结果和临床应用效果。结果:肱三头肌长头支与腋神经相隔于长头本身,转位方便,其横径与腋神经前、后支横径相近,便于吻合。临床应用6例,术后经随访6～16个月,4级以上肌力5例,3级肌力1例,伸肘无影响。结论:桡神经肱三头肌长头支转位修复腋神经,术式简便,容易操作,适用于臂丛部分损伤、肱三头肌正常的腋神经瘫的修复。BACKGROUND:Axillary nerve injury is very common in clinic with different methods in the treatment as well as different effectiveness,of which most of the treatments require sacrifice of the function of one adjacent nerve. OBJECTIVE:To introduce the anatomic features and the effectiveness in clinical application of the branch to the long head of triceps brachii from radial nerve in the restoration of axillary nerve. DESIGN:A vertical observatory study along with the direction of nerve stem was conducted. SETTING and PARTICIPANTS:Data were collected from Guangzhou First People's Hospital Affiliated to Guangzhou Medical College.Sixteen perfused adult corpse specimens and 6 patients admitted by our hospital were selected in our study. METHODS:Sixteen perfused adult corpse specimens were used for routine exposure of axillary nerve and the branches to long head of triceps brachii to observe the number of the branches of axillary nerve and the subbranches of the branch of radial nerve,and the relationship of abut,as well as the calibre of each nerve branches were measured.The anatomic features observed were perspectively applied on 6 clinical patients.All patients were received a postoperative follow up and periodically check up of the muscular force dominated by axillary nerve. MAIN OUTCOME MEASURES:The results of anatomic observation and the effectiveness of clinical application. RESULTS:The branch to long head of triceps brachii was apart from axillary nerve by the long head itself;therefore,it was every easy to transposition;the horizontal calibre of long head branch was close to those of the anterior and posterior branches of axillary nerve,which was easy to anastomoses.In 6 clinical applied patients,after a postoperative follow up of 6 to 16 months,it was found that there were 5 cases with grade Ⅳ+ muscular force and one case with grade Ⅲ muscular force,and there was no impact on the extension of elbow. CONCLUSION:The procedure is simple and easy to manipulate.It is suitable for the restoration of a

关 键 词：臂丛 周围神经 腋神经 创伤和损伤 

分 类 号：R745.4[医药卫生—神经病学与精神病学]