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首页> 外文期刊>Journal of Brachial Plexus and Peripheral Nerve Injury >Clinical and neuropathological study about the neurotization of the suprascapular nerve in obstetric brachial plexus lesions
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Clinical and neuropathological study about the neurotization of the suprascapular nerve in obstetric brachial plexus lesions

机译：臂丛神经病变中肩cap上神经神经化的临床和神经病理学研究

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BackgroundThe lack of recovery of active external rotation of the shoulder is an important problem in children suffering from brachial plexus lesions involving the suprascapular nerve. The accessory nerve neurotization to the suprascapular nerve is a standard procedure, performed to improve shoulder motion in patients with brachial plexus palsy.MethodsWe operated on 65 patients with obstetric brachial plexus palsy (OBPP), aged 5-35 months (average: 19 months). We assessed the recovery of passive and active external rotation with the arm in abduction and in adduction. We also looked at the influence of the restoration of the muscular balance between the internal and the external rotators on the development of a gleno-humeral joint dysplasia. Intraoperatively, suprascapular nerve samples were taken from 13 patients and were analyzed histologically.ResultsMost patients (71.5%) showed good recovery of the active external rotation in abduction (60°-90°). Better results were obtained for the external rotation with the arm in abduction compared to adduction, and for patients having only undergone the neurotization procedure compared to patients having had complete plexus reconstruction. The neurotization operation has a positive influence on the glenohumeral joint: 7 patients with clinical signs of dysplasia before the reconstructive operation did not show any sign of dysplasia in the postoperative follow-up.ConclusionThe neurotization procedure helps to recover the active external rotation in the shoulder joint and has a good prevention influence on the dysplasia in our sample. The nerve quality measured using histopathology also seems to have a positive impact on the clinical results.
机译：背景技术对于患有肩cap上神经的臂丛神经病变的患儿，肩关节主动外旋缺乏恢复是一个重要问题。肩cap上神经的副神经神经化是一种标准手术，旨在改善臂丛神经麻痹患者的肩部运动。方法我们对65名年龄在5-35个月的产科臂丛神经麻痹（OBPP）患者进行了手术（平均：19个月） 。我们评估了手臂外展和内收时被动和主动外旋转的恢复情况。我们还研究了内部和外部旋转肌之间的肌肉平衡恢复对盂肱肱关节发育异常的影响。术中从13例患者中收集了肩cap上神经样本并进行了组织学分析。结果大多数患者（71.5％）在外展（60°-90°）时表现出良好的活动性外旋恢复。与内收相比，外展时手臂外展获得了更好的结果，与仅进行神经化手术的患者相比，神经丛完全重建的患者获得了更好的结果。神经化手术对盂肱关节有积极影响：7例在重建手术前有临床异常增生迹象的患者在术后随访中未显示任何异常增生迹象。结论神经化手术有助于恢复肩部活动性外旋关节，并且对我们样本中的不典型增生有很好的预防作用。使用组织病理学测量的神经质量似乎也对临床结果产生积极影响。

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