肌腱转位术治疗桡神经损伤晚期功能障碍疗效观察

发布时间：2018-03-22 01:15

本文选题：肌腱转位术　切入点：桡神经损伤　出处：《中国修复重建外科杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的总结肌腱转位术治疗桡神经损伤晚期功能障碍的疗效。方法回顾分析2012年2月—2015年3月采用肌腱转位术治疗的12例桡神经损伤晚期功能障碍患者临床资料。其中男9例,女3例;年龄12~45岁,平均28岁。交通事故伤致肱骨干骨折并桡神经离断6例,肱骨内固定物取出时医源性损伤3例,机器绞伤致软组织神经缺损3例。一期手术均未行神经修复,术后12~18个月、平均14个月出现桡神经损伤晚期功能障碍症状。其中桡神经主干损伤8例,桡神经深支损伤4例。术前患者均出现垂腕畸形,腕关节背伸肌力0级,屈曲肌力5级。结果术后患者切口均Ⅰ期愈合。12例均获随访,随访时间6~12个月,平均8.5个月。末次随访时,患者腕关节背伸活动可、肌力3级,屈曲肌力4级。根据费起礼等和陈德松等疗效评定法,获优7例,良3例,可2例,优良率83.3%。结论肌腱转位术治疗桡神经损伤晚期功能障碍临床效果满意。
[Abstract]:Objective to summarize the efficacy of tendon transposition in the treatment of late radial nerve dysfunction. Methods the clinical data of 12 patients with advanced radial nerve dysfunction treated by tendon transposition from February 2012 to March 2015 were retrospectively analyzed. Three cases were female, the age was 1245 years old (mean 28 years). 6 cases of fracture of the shaft of humerus caused by traffic accident, 3 cases of iatrogenic injury when the internal fixation of humerus were taken out. There were 3 cases of soft tissue nerve defect caused by mechanical strangulation. No nerve repair was performed at the first stage of operation. The symptoms of late functional disturbance of radial nerve injury occurred in 12 ~ 18 months postoperatively, in which there were 8 cases of radial nerve trunk injury. There were 4 cases of deep branch injury of the radial nerve. All the patients had the deformity of the wrists before operation. The wrist dorsal extensor muscle force was 0, and the flexion muscle strength was grade 5. Results all the patients were followed up for 6 ~ 12 months, all the incisions were healed in the first stage and 12 cases were followed up. The average time was 8.5 months. At the last follow-up, the wrist joints showed good dorsal extension activity, grade 3 muscle strength, and grade 4 flexion muscle strength. According to the evaluation method of Fei Kai Li et al and Chen Desong, 7 cases were excellent, 3 cases were good, 2 cases were fair. Conclusion the clinical effect of tendon transposition in the treatment of late radial nerve injury dysfunction is satisfactory.
【作者单位】：安徽医科大学附属省立医院骨科;
【分类号】：R688

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