Clinical outcomes following median to radial nerve transfers.
Clinical outcomes following median to radial nerve transfers.
复制标题
DOI：
10.1016/j.jhsa.2010.09.034
复制
发表时间：
2011-02
期刊：
影响因子：
--
通讯作者：
Mackinnon SE
中科院分区：
文献类型：
--
作者：
Ray WZ;Mackinnon SE
在这项研究中，作者评价了桡神经麻痹患者的临床结局，这些患者接受了利用正中神经（支配指浅屈肌和桡侧腕屈肌）的冗余神经束至骨间后神经和桡侧腕短伸肌的神经的神经转移。回顾性分析了19例桡神经损伤患者的临床记录，这些患者接受了使用正中神经作为供体神经的神经转移手术。所有患者均采用医学研究理事会（MRC）分级系统进行评价。患者的平均年龄为41岁（范围17 - 78岁）。所有患者均接受了至少12个月的随访（20.3 ± 5.8个月）。平均在损伤后5.7 ± 1.9个月进行手术。根据以下量表对术后功能评价进行分级：MRC 0/5 - MRC 2/5级被认为是不良结局，而MRC 3/5级被认为是一般结局，MRC 4/5级被认为是良好结局，4+/5级被认为是极好结局。17名患者（89%）有一个完全的桡神经麻痹，而两名患者（11%）有完整的手腕伸展，但没有手指或拇指伸展。术后，除1例患者外，所有患者的腕关节伸展恢复良好至极佳。12例患者恢复良好至极佳的手指和拇指伸展，2例患者恢复一般，5例患者恢复较差。桡神经是一种常见的神经损伤，在受影响的患者中引起显著的发病率。正中神经为桡神经再支配提供了可靠的神经束来源。这种转移首次于1999年进行，并在随后的十年中不断发展。手术技术和运动再教育的重要的细微差别，这一转移的成功至关重要已被确定和讨论。
In this study the authors evaluate the clinical outcomes in patients with radial nerve palsy who underwent nerve transfers utilizing redundant fascicles of median nerve (innervating the flexor digitorum superficialis and flexor carpi radialis muscles) to the posterior interosseous nerve and the nerve to the extensor carpi radialis brevis. A retrospective review of the clinical records of 19 patients with radial nerve injuries who underwent nerve transfer procedures using the median nerve as a donor nerve were included. All patients were evaluated using the Medical Research Council (MRC) grading system. The mean age of patients was 41 years (range 17 – 78 years). All patients received at least 12 months of follow-up (20.3 ± 5.8 months). Surgery was performed at a mean of 5.7 ± 1.9 months post-injury. Post-operative functional evaluation was graded according to the following scale: grades MRC 0/5 - MRC 2/5 were considered poor outcomes, while MRC of 3/5 was a fair result, MRC grade 4/5 was a good result, and grade 4+/5 was considered an excellent outcome. Seventeen patients (89%) had a complete radial nerve palsy while two patients (11%) had intact wrist extension but no finger or thumb extension. Post-operatively all patients except one had good to excellent recovery of wrist extension. Twelve patients recovered good to excellent finger and thumb extension, two patients had fair recovery, five patients had a poor recovery. The radial nerve is a commonly injured nerve, causing significant morbidity in affected patients. The median nerve provides a reliable source of donor nerve fascicles for radial nerve reinnervation. This transfer was first performed in 1999 and evolved over the subsequent decade. The important nuances of both surgical technique and motor re-education critical for to the success of this transfer have been identified and are discussed.
登录
查看更多内容
影响因子：
4.8
作者：
Brown, Justin M.;Yee, Andrew;Mackinnon, Susan E.
通讯作者：
Mackinnon, Susan E.
影响因子：
2.1
作者：
Elton, Suzanne G.;Rizzo, Marco
通讯作者：
Rizzo, Marco
影响因子：
2.4
作者：
Roganovic, Z.;Ilic, S.;Savic, M.
通讯作者：
Savic, M.
影响因子：
3.6
作者：
Bezuhly, Michael;Sparkes, Gerald L.;Lalonde, Donald H.
通讯作者：
Lalonde, Donald H.
影响因子：
4.1
作者：
Mackinnon, Susan E.;Roque, Brandon;Tung, Thomas H.
通讯作者：
Tung, Thomas H.