胸内侧神经移位吻接肌皮神经重建屈肘功能

Medial thoracic nerve transfer to musculocutaneous nerve for reconstruction of elbow flexion.

臂丛神经颈５．６根性或上干撕脱伤无法修复时，常用隔神经、肋间神经、胸背神经等移位吻接肌皮神经以恢复屈肘功能。为寻找新的术式以供选择，通过解剖研究和临床应用４例，发现胸内侧神经与肌皮神经相距较近，可无张力直接缝合；胸内侧神经有３～４分支，移位时保留１个分支，术后胸大肌胸肋头肌力可恢复到２～３级。本术式为臂丛根部撕脱伤后，重建屈肘功能的一个较好的神经修复方法．

Abstract The paper reported a new design of anastomosing the medial thoracic nerve to musculocutaneous nerve and its Practicein four cases. The anatomy relating to the operation has beenresearched. The operative procedure and followed - up resulthave beed described in detail. The study presented that the operation had several advantages such as less operative injury,safety, seeking for donor - donee nerve easily and so on. Weconclud that the new design is a better method for functionalrecovery of elbow flexion in patient with C5,6 nerve roots orupper trunk avulsion,especially effectiveness on whose havingphrenic nerve to be untransferred resulted from C4 nerve rootsinvolved or complicating multicostal fracture resulting in thelimitation of transfer intercostal nerve.