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延迟神经重建手臂损伤:风险值得回报吗?

Alvin Wong¹, Ying-Hsuan Lee², Tommy Nai-Jen Chang²

¹1Department of Surgery, Division of Plastic and Reconstructive Surgery, Virginia Commonwealth University, Richmond, Virginia; and.

Journal of neurosurgery

|October 20, 2023

概括

由于手臂损伤 (BPIs) 的延迟神经重建,在非pan-plexus病例中有效地恢复功能. 然而,对于泛复合体BPI来说,结果是不一致的,需要仔细管理捐赠神经.

科学领域:

整形外科整形外科整形外科
神经外科神经外科
重建性手术是一种重建性手术.

背景情况:

臂损伤 (BPIs) 通常需要神经重建.
由于潜在的捐赠神经不可靠性,延迟的重建 (受伤后6-12个月) 带来了挑战.
在严重的BPI中,关键的捐赠神经可能会被浪费在不确定的结果上.

研究的目的:

在BPIs中延迟神经重建后评估肘部和肩部的长期功能结果.
为了比较非泛复合和泛复合BPIs之间的结果.
评估神经移植和移植在延迟BPI管理中的有效性.

主要方法:

从1999年至2020年接受神经移植/移植的BPI患者的回顾性分析.
分类为非泛复合 (C5-8) 和泛复合 (C5-T1) 的BPI组.
可接受结果的定义:肘部曲≥M3或肩部拉伸≥60°.

主要成果:

分析了64名患者;平均重建时间为236天,随访66个月.
非泛复合体的BPI:74.4%实现M3,48.8%M4肘部曲;53.5%可接受的肩部绑架.
泛plexus BPIs: 38.1% M3, 23.8% M4 肘部曲; 23.5% 可接受的肩膀绑架.

结论:

延迟的神经重建有效地恢复肘部和肩部功能在非泛神经脉冲中.
泛plexus BPIs 显示功能恢复与延迟重建不一致.
审慎的捐赠神经使用和备用策略 (例如,肌肉移植) 对于泛plexus BPIs至关重要.

关键词:

臂状交损伤的受伤神经移植神经移植神经转移神经转移神经转移神经转移这是外围神经.亚急性神经损伤是什么意思

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