INTERCOSTAL NERVE TRANSFER OF THE MUSCULOCUTANEOUS NERVE IN AVULSED BRACHIAL-PLEXUS INJURIES - EVALUATION OF 66 PATIENTS

被引：148

作者：

CHUANG, DC

YEH, MC

WEI, FC

机构：

[1] Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei

来源：

JOURNAL OF HAND SURGERY-AMERICAN VOLUME | 1992年 / 17A卷 / 05期

关键词：

D O I：

10.1016/0363-5023(92)90451-T

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Intercostal nerve transfer is a well-established and effective technique for irreparable avulsed brachial plexus injuries. Between 1987 and 1989, 66 patients with brachial plexus injuries were treated by means of intercostal nerve transfer to the musculocutaneous nerve, with or without nerve grafts to obtain elbow flexion. The results were evaluated. Five clinical signs-(1) induction of chest pain by squeezing of biceps, (2) proximal biceps contraction, (3) distal biceps contraction, (4) active elbow flexion against gravity, and (5) active elbow flexion against weight-were identified and used as a guide for functional recovery. The overall success rate with motor function of grade 4 or more was 67%. The motor results were better in 1989 (81%) because of greater familiarity with the anatomy and improved surgical technique. The important factors in obtaining a good result are (1) early exploration (less than 5 months after trauma), (2) use of three intercostal nerves, (3) mixed nerve-to-mixed nerve coaptation, (4) nerve repair without grafts and under no tension, and (5) shoulder stability.

引用

页码：822 / 828

页数：7

共 16 条

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