改良Mayer法斜方肌移位重建肩外展功能

Reconstruction of shoulder abduction with modified Mayer's trapezius transfer

目的 介绍应用斜方肌移位治疗肩外展功能障碍的手术方法。方法 根据肩外展运动的生物力学原理 ,结合斜方肌的解剖学特点 ,采用改良Mayer法 (在Mayer法的基础上加用异体肌腱 )对 5例臂丛上干损伤肩外展不能者进行治疗。结果 术后平均随访 1 8个月 ,按中华医学会手外科学会上肢部分功能评定试用标准评定 ,优 3例 ,良 1例 ,差 1例。结论 臂丛上干不可逆损伤所致的三角肌麻痹 ,如肩关节周围其它肌肉肌力基本正常者 ,采用改良Mayer法斜方肌移位重建肩外展功能是有效的。

Objective To introduce the operation procedure of trapzius transfer for reconstruction of shoulder abduction. Mothods According to the biomechanical principle of shouder abduction in combination with trapezius anatomical characteristics, modified Mayer's (Mayer's transfer and heterogeneous tendon) was used in 5 cases of shoulder abduction disability due to injury of upper root of brachial plexus. Results Follow up averaged 18 months. According to function assessment standard in upper extremity issued by institute of Hand Surgery of Chinese Medicine Associate, excellent results were obtained in 3 cases, good in one and bad in one. Conclusions Modified Mayer's method transfer is an effective approach for reconstruction of shoulder abduction in patients with deltoid paralysis suffered from brachial plexus upper root injury,if the other shoulder muscles function near normally.