选择性正中、尺神经部分束联合副神经移位治疗颈5,6根性撕脱伤  

Treatment of C_5,C_6 root avulsion by selective partial fascicles transfer of median and ulnar nerves combined with trapezius branch transfer of accessory nerve

作　　者：顾立强[1] 陈国奋[1] 李绍光[1] 相大勇[1] 邵岩[1] 裴国献[1] 

机构地区：[1]第一军医大学南方医院全军创伤骨科中心,广州市510515

出　　处：《中华创伤骨科杂志》2003年第3期168-170,共3页Chinese Journal of Orthopaedic Trauma

基　　金：广东省科技攻关项目(2002C31003);广东省医学科技研究基金(A1999333)~~

摘　　要：目的探讨选择性正中、尺神经部分束联合副神经移位治疗臂丛颈5、6根性撕脱伤的疗效。方法22例臂丛颈5、6根性撕脱伤,行选择性正中神经内侧一神经束移位修复腋神经外侧半、尺神经内侧一神经束移位修复肌皮神经肱二头肌支,联合副神经斜方肌支移位修复肩胛上神经。结果术后时间超过12月随访16例,平均随访24月。15例屈肘100°～150°,肌力M4～M5;肩外展90°～120°,肌力M3～M4。1例屈肘90°;肩外展75°。按中华手外科学会标准,优15例,良1例。结论选择性正中、尺神经部分束联合副神经斜方肌支移位治疗臂丛颈5、6根性撕脱伤,可很好恢复屈肘、肩外展功能,且手术简便、功能恢复时间较短。Objective To explore the effects of selective partial fascicles transfer of the median nerve and ulnar nerve combined with the accessory nerve transfer to treat C5,C6 root avulsion of brachial plexus. Methods 22 cases of the C5,C6 root avulsion of brachial plexus were treated. A fascicle of medial part of the median nerve was selectively transfered to repair the lateral fascicles of axillary nerve, a fascicle of ulnar nerve to repair biceps branch of musculocutaneous nerve, and the trapezius branch transfer of accessory nerve to repair suprascapular nerve. Results Follow ups were carried out in 16 cases for more than 12 months postoperatively, averaging 24 months. In 15 patients their elbow flexion were 100° ～ 150° and M4～ M5, and the shoulder adduction was 90° ～ 120° and M3～ M4. According to the standard of Chinese Association of Hand Surgery, 15 of them were excellent and one was good. Conclusion Selective partial fascicles transfer of the median nerve and ulnar nerve combined with the trapezius branch transfer of accessory nerve ,was an effective and convenient treatment method of C5,C6 root avulsion of brachial plexus. It can restore better function of elbow flexion and shoulder addction in a short time.

关 键 词：正中神经 尺神经 副神经移位 治疗 根性撕脱伤 Oberlin术式 

分 类 号：R651.3[医药卫生—外科学]