旋前圆肌肌支联合肱肌肌支移位重建臂丛神经中下干损伤屈指功能的临床研究  

Clinical study of nerve transfer of pronator teres branch and brachialis branch for reconstructing finger flexion after C8 to T1 or C7 to T1 brachial plexus avulsions

作　　者：许彬 童劲松 张成钢 董震 Xu Bin;Tong Jinsong;Zhang Chenggang;Dong Zhen(Department of Hand Surgery,Huashan Hospital,Fudan University,Shanghai 200040,China;NHC Key Laboratory of Hand Reconstruction(Fudan University),Shanghai 200032,China;Shanghai Key Laboratory of Peripheral Nerve and Microsurgery,Shanghai 200032,China;Institute of Hand Surgery,Shanghai 200040,China;Institute of Hand Surgery,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院手外科,上海200040 [2]卫健委手功能重建重点实验室,上海200032 [3]上海市周围神经显微外科重点实验室,上海200032 [4]上海市手外科研究所,上海200040 [5]复旦大学手外科研究所,上海200040

出　　处：《中华手外科杂志》2024年第1期85-88,共4页Chinese Journal of Hand Surgery

基　　金：国家自然科学基金项目(81802850);上海市科委项目(18YF1402900);上海市临床重点专科(shslczdzk05601);上海市周围神经显微外科重点实验室(20DZ2270200)。

摘　　要：目的报告旋前圆肌肌支联合肱肌肌支移位术重建臂丛神经中、下干损伤屈指功能的临床疗效。方法对8例臂丛神经颈_(7)-胸_(1)撕脱伤、2例臂丛颈_(8)-胸_(1)撕脱伤患者行旋前圆肌肌支联合肱肌肌支移位术,术后随访2年以上,并随访屈指肌力、肌电及握力。结果术后随访91.4个月,10例患者均无前臂旋前、屈肘功能下降。9例(9/10)患者术后屈指肌力至少达到M_(3),其中6例患者术后屈指肌力达到M_(4),患者平均握力达3.7 kg。结论旋前圆肌肌支联合肱肌肌支移位术是安全、有效的,该术式能提高臂丛中、下干损伤患者的屈指力量。Objective To report the clinical efficacy of nerve transfer of pronator teres branch and brachialis branch for reconstructing finger flexion after C_(8) to T_(1) or C_(7) to T_(1) brachial plexus avulsions.Methods Nerve transfer of pronator teres branch and brachialis branch was performed on 8 patients with C_(7) to T_(1) brachial plexus avulsion injury and 2 patients with C_(8) to T_(1) brachial plexus avulsion injury.The postoperative follow-up was more than 2 years,and then finger flexion strength,electromyography and grip strength were assessed.Results The postoperative follow-up was 91.4 months,and none of the 10 patients had functional deficits of forearm pronation or elbow flexion.The postoperative finger flexion strength of 9 patients(9/10)reached at least M_(3),of which 6 patients reached M_(4) after surgery,and the average grip strength of patients reached 3.7 kg.Conclusion Nerve transfer of pronator teres branch and brachialis branch is safe and effective,and this procedure can improve the finger flexion strength for patients with C_(8) to T_(1) or C_(7) to T_(1) brachial plexus avulsions.

关 键 词：神经移位 臂丛 旋前圆肌 肱肌 

分 类 号：R658.2[医药卫生—外科学]