Abstract

目的 探讨健侧C7神经经椎体前路移位、一期直接修复臂丛根部撕脱伤的临床疗效.方法 对臂丛根性撕脱伤伤后1~3个月行健侧C7神经经椎体前路移位直接修复术16例.在健侧C7神经前、后股汇入外侧束、后束平面后作显微解剖分离以切取健侧C7的最大长度.健侧C7神经均可顺利经前斜角肌内侧隧道-椎体前路引至患侧,一期与患侧C8、T1-下干直接缝合10例,与患侧C5、6-上千直接缝合4例,与患侧C6、C8神经根直接缝合2例.结果 健侧C7根干前、后股切取长度分别为(7.71±1.16)和(6.97±1.18)cm.一期直接修复c8、T1-下干组经6~18个月随访8例,术后6个月尺、正中神经Tinel征阳性平面至肘关节.有2例术后9个月胸大肌胸肋部收缩(M3),术后12~18个月,手掌、手指与前臂内侧均有触痛觉恢复,尺侧腕屈肌和示、中、环、小指屈肌收缩(M3).结论 健侧颈7神经经椎体前路移位、一期直接修复C8、T1-下干的手术设计具有可操作性,是治疗臂丛根部撕脱伤的有效方法。

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