正中神经部分束支移位重建屈肘功能的临床应用

Clinical Use of Partial Median Nerve Fascicle Transfer for Reconstruction of Elbow Flexion

目的:总结应用正中神经部分束支移位与肌皮神经肱二头肌肌支重建屈肘功能的治疗效果。方法:5例臂丛神经上干根性损伤者,采用正中神经部分束支移位与肌皮神经肱二头肌肌支缝合术。术中切取正中神经后内侧,横截面的1/6为移位束支。结果:术后对患肢正中神经功能的影响轻微;患者均出现手部麻木、疼痛等感觉异常,对手部肌力无明显影响。经1～3年的随访,5例患者均在10～12个月恢复了屈肘功能。根据肱二头肌肌力恢复情况及肘关节活动范围,优3例,可2例。结论:正中神经部分束支移位于肌皮神经肱二头肌肌支是治疗臂丛神经上干型根性撕脱伤、重建屈肘功能的一种简单有效、安全可靠的手术方法。

Objective. To summarize the clinical effects of partial median nerve fascicle transfer to biceps muscle branch of the musculocutaneous nerve for reconstruction of elbow flexion. Methods： 5 patients who sustained injury of the upper trunk of brachial plexus underwent nerve transfer using a part of the median nerve to the biceps muscular branch of the musculocutaneous nerve. The posteromedial portion accounting for 1/6 of the median nerve was harvested as neurotizer. Results. The effects of the donor median nerve function were minor after operation. All patients had numb and pain in the hand, but there were no significant effects of hand strength. Follow-up period ranged from one to three years. According to biceps strength and range of motion of elbow flexion, 3 cases are good, 2 are okay. Conclusion.Partial median nerve transfer might be a simple , safe and effective procedure for brachial plexus upper trunk avulsions and elbow flexion reconstruction.