CAJ | 학술논문

目的采用多组神经部分束支就近移位至受区神经的方法,重建臂丛神经上干损伤后肩肘功能.方法自2009年10月至2012年12月共收治6例臂丛神经上干损伤患者,分别行副神经到肩胛上神经、桡神经肱三头肌长头肌支到腋神经前支及尺神经部分束支到肱二头肌肌支等受区局部神经移位术.结果 6例患者术后均获得随访,时间为10个月至3年.术后4～6个月肩外展和屈肘功能均不同程度恢复.术后1年肩外展外旋及屈肘活动范围接近正常.1例患者术后出现环、小指感觉减退,观察1年症状明显减轻.结论采用多组神经部分束支就近移位至受区神经的方法重建臂丛神经上干损伤后肩肘功能,具有操作简便、恢复时间短、手术效果可靠等优点,值得推广.
목적 채용다조신경부분속지취근이위지수구신경적방법,중건비총신경상간손상후견주공능.방법 자2009년10월지2012년12월공수치6례비총신경상간손상환자,분별행부신경도견갑상신경、뇨신경굉삼두기장두기지도액신경전지급척신경부분속지도굉이두기기지등수구국부신경이위술.결과 6례환자술후균획득수방,시간위10개월지3년.술후4～6개월견외전화굴주공능균불동정도회복.술후1년견외전외선급굴주활동범위접근정상.1례환자술후출현배、소지감각감퇴,관찰1년증상명현감경.결론 채용다조신경부분속지취근이위지수구신경적방법중건비총신경상간손상후견주공능,구유조작간편、회복시간단、수술효과가고등우점,치득추엄.
Objective To reconstruct shoulder and elbow function in patients with upper tnunk brachial plexus injuries using multiple distal nerve transfers.Methods From October 2009 to December 2012,6 patients with upper trunk brachial plexus injuries were treated with simultaneous transfer of the spinal accessory nerve to the suprascapular nerve,triceps long head branch of the radial nerve to anterior branch of the axillary uerve,and partial ulnar nerve fascicle to biceps muscle branch.Results All 6 patients were follow-up for 10 months to 3 years postoperatively.Partial functional recovery of the shoulder and elbow joints was observed 4 to 6 months after the surgery.Shoulder abduction and external rotation,and elbow flexion were near normal one year postoperatively.Decreased sensation of the ring finger and little finger occurred in one patient which was relieved one year after the operation.Conclusion Multiple nerve transfer closer to the recipient nerves has such advantages as being a simpler procedure,faster functional recovery and reliable surgical outcomes.It is a worthy procedure for restoring shoulder and elbow functions in upper trunk brachial plexus injuries.