肱肌肌支移位重建屈指功能的远期疗效

Long-term follow-up of brachialis muscle branch transfer for finger flexion

目的报道肌皮神经肱肌肌支移位后的远期疗效。方法对3例行肌皮神经肱肌肌支移位至屈指肌支者,术后随访2年以上,并测定其肌力与肌电。结果2例术前C5、6神经支配肌群良好者(肌力4°,肌电为单纯混合相),术后屈指功能恢复良好(肌力3°,肌电为单纯或单纯混合相)。另1例术前C5、6支配肌群仅个别肌肉良好(肌力3°,肌电为单纯相),术后功能未恢复。结论肱肌肌支的功能状态是影响术后疗效的主要因素,术前C5、6神经根支配的肌群功能状态全面良好者,肱肌肌支移位术后屈指功能恢复良好。

Objective To report the long-term outcome of brachialis muscle branch transfer, Methods 3 cases of brachialis muscle branch transfer to the finger flexor nerve fascicles were evaluated. The patients were followed for 2 years. Muscle power and electromyography （EMG） were examined. Results Good recovery of finger flexion was observed in 2 patients who had good preoperative function of all C5, C6 innervated muscles （muscle power 4°, sitagle-mixed pattern at EMG recruitment）, Muscle power of the finger flexors reached 4°. Recruitment of these muscles at EMG showed single pattern or single-mixed pattern. In the other case in which only few C5, C6 innervated muscles had good preoperative function （ muscle power 3°, single pattern at EMG recruitment ）, no recovery was seen. Conclusion The quality of the brachialis muscle branch is the major factor that determines the outcome of neurotization procedure. Good recovery of finger flexion could be expected if preoperative function of C5 , C6 innervated muscles is generally good.