带神经血管蒂的背阔肌移位治疗三角肌瘫痪  

TREATMENT OF DELTOID MUSCLE PARALYSIS WITH PEDICLE MERVE BLOOD LATISSIMUS DORSI DISPLACEMENT

作　　者：李志忠[1] 王德就[1] 王国普[1] 

机构地区：[1]暨南大学医学院第一附属医院骨科

出　　处：《中华显微外科杂志》1997年第4期264-266,共3页Chinese Journal of Microsurgery

摘　　要：目的：对背阔肌移位治疗三角肌瘫痪的临床疗效进行分析和比较，以探讨治疗三角肌瘫痪的最佳方法。方法：用带神经血管蒂的背阔肌肌瓣移位代替瘫痪的三角肌，近端固定在锁骨的外１／３、肩峰、肩胛冈，远端固定在三角肌结节的下方。术后肩外展９０°，前屈３０°位固定。术后１周开始肌肉的主动运动，逐步增加肌肉的收缩力，四周后去除外固定。结果：本组５例术后移位肌肉肌力均达Ⅲ级以上，３例肩关节上举＞７０°，２例５０°～７０°。结论：带神经血管蒂的背阔肌移位代替三角肌是一种治疗三角肌瘫痪的较好的手术方式，其临床疗效优于其他方法。Objective:Analyze and compare the clinic curing results of latissimus dorsi displacement to treat deltoid muscle paralysis and to seek the best method of curing deltoid muscle paralysis Methods:Use the displacement latissimus dorsi to replace the paralytic deltoid muscle The near distrenity is fixed on the scapula and the ridge of the scapula The distant end is fixed on the humerus under the tubercle of the deltoid muscle After operation,the joint of the shoulder is fixed on the 90 degree of abduction,with 45 degree of front bent One week after operation the slight initiative muscle contraction begins,then the muscle contracting power will be strengthened step by step Four weeks after operation the outer fix is removed Results:After the operation,the power of the muscle reached level Ⅲ and above Of the five cases,three shoulder can lift more than 70 degree and two can lift 50～70 degree Conclusions:Replacing the deltoid muscle using the pedicle nerve blood latissimus dorsi displacement is a better operation method of treating of the deltoid muscle paralysis The clinic curative effect in this way is more desirable in other ways

关 键 词：三角肌瘫痪 肌肉移位 背阔肌 脊髓灰质炎 后遗症 

分 类 号：R682.210.5[医药卫生—骨科学]