全臂丛神经损伤残留神经根与下干直接缝合重建屈指功能疗效

The clinical study of direct coaptation of the residual nerve root with the lower trunk for finger flexion reconstruction in patient with total brachial plexus injury

目的：观察全臂丛神经损伤患者行残留神经根与下干直接缝合术后屈指功能恢复的临床效果。方法2009年5月—2011年11月，对11例全臂丛神经损伤患者行患侧下干与残留神经根直接缝合术。C5与下干或内侧束或C8神经根直接缝合5例；C6与下干或内侧束直接缝合4例； C7与内侧直接缝合1例；上干后股起始处与内侧束直接缝合1例。结果术后随访36~60个月，平均46个月。屈指肌力达到3级或以上的比率：中、环、小指为72.7%（8/11）；拇、食指为54.5%（6/11）；屈腕肌力3级或以上比率为72.7%（8/11）。结论残留神经根与下干直接缝合重建屈指功能效果满意。

Objective To follow up the results of direct coaptation of the residual nerve root with lower trunk in patients suffered with global brachial plexus injury. Methods From May 2009 to Nov 2005, 11 patients including 10 males and 1 female with complete brachial plexus lesions were performed the procedure of residual nerve root direct coaptation with the lower trunk. The C5 used to graft to the lower trunk was in 5 cases, C6 in 4 cases, and C7 in 1 case, and the posteriov division of the upper trunk in 1 case. Results The follow up period was 36-60 months, with an average 46 months. Motor function with a grade of M3 or greater was attained in 72.7%（8/11） of the patients for little, ring and middle finger flexion, 54.5%（6/11）of the patients for thumb and index flexion, and 72.7 （8/11） of the patients for wrist flexion. Conclusion The results of finger flexion achieved after direct coaptation of residual nerve root with lower trunk in patient with global brachial plexus injury were satisfactory.