A comparison of functional outcomes for triceps motor branch transfer to the anterior division axillary nerve in upper trunk brachial plexus injuries versus non-brachial plexus axillary nerve injuries.

IF 3.3 2区 医学 Q2 CLINICAL NEUROLOGY
Mikaela H Sullivan, Ava G Chappell, Robert J Spinner, Nicholas Pulos, Allen T Bishop, Alexander Y Shin
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Abstract

Objective: Triceps motor branch transfer to the anterior division of the axillary nerve (AXN) was originally described for patients with a loss of deltoid function secondary to upper trunk (UT) brachial plexus injuries but has evolved to restore deltoid function in isolated peripheral AXN injuries. The purpose of this study was to compare functional outcomes in patients who had undergone this procedure in the setting of UT brachial plexus injury versus peripheral AXN injury.

Methods: The records of patients who had undergone triceps branch to anterior division of the AXN transfer at a single academic institution between 2001 and 2023 were retrospectively reviewed. Patients were included in the study if they had either a UT or an AXN injury and were excluded if their follow-up was less than 2 years. Pre- and postoperative outcomes, including modified British Medical Research Council grade and range of motion, were compared between the two groups.

Results: Forty-two patients met the criteria for inclusion. Thirty cases were classified as UT injury and 12 cases as AXN injury. The mean postoperative abduction strength was significantly higher in the AXN injury group (3.2 ± 1.5 vs 1.9 ± 1.2, p = 0.007), as was the postoperative change in abduction strength (2.8 ± 1.7 vs 1.6 ± 1.4, p = 0.01). The mean postoperative forward flexion (136° ± 57° vs 79° ± 54°, p = 0.005) and abduction (129° ± 64° vs 59° ± 47°, p = 0.004) were significantly better in the AXN group, although postoperative changes in flexion and abduction were not different between the groups. Triceps strength preoperatively was similar to that postoperatively in both groups.

Conclusions: Patients with an AXN injury, compared to those with a UT injury, had better postoperative abduction strength and shoulder range of motion after triceps branch transfer to the anterior division of the AXN. Triceps strength was not significantly changed after the procedure in the two groups. The study findings suggest that the outcomes of triceps branch transfer to the anterior division of the AXN are different based on the location and type of injury, providing insight into prognosis while counseling patients.

肱三头肌运动分支转移至臂丛上干损伤与非臂丛腋窝神经损伤三头肌运动分支转移至腋窝神经前段的功能结局比较。
目的:肱三头肌运动分支转移至腋窝神经(AXN)前段最初被描述为继发于臂丛上干(UT)损伤的三角肌功能丧失的患者,但已经发展到恢复孤立的周围AXN损伤的三角肌功能。本研究的目的是比较在UT臂丛损伤和外周AXN损伤的情况下接受这种手术的患者的功能结果。方法:回顾性分析2001年至2023年在同一学术机构行肱三头肌分支至前侧AXN转移术的患者记录。如果患者有UT或AXN损伤,则纳入研究,如果随访时间少于2年,则排除在外。比较两组患者的术前和术后结果,包括改良的英国医学研究委员会分级和活动范围。结果:42例患者符合纳入标准。UT损伤30例,AXN损伤12例。AXN损伤组术后平均外展强度显著高于对照组(3.2±1.5 vs 1.9±1.2,p = 0.007),术后外展强度变化显著高于对照组(2.8±1.7 vs 1.6±1.4,p = 0.01)。AXN组术后平均前屈(136°±57°vs 79°±54°,p = 0.005)和外展(129°±64°vs 59°±47°,p = 0.004)明显更好,尽管两组术后屈曲和外展的变化没有差异。两组术前肱三头肌力量与术后相似。结论:与UT损伤患者相比,AXN损伤患者在肱三头肌分支转移至AXN前段后具有更好的术后外展力量和肩部活动范围。手术后两组肱三头肌力量无明显变化。研究结果提示,肱三头肌分支转移至AXN前段的结果因损伤部位和类型的不同而不同,为患者提供预后指导。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Neurosurgical focus
Neurosurgical focus CLINICAL NEUROLOGY-SURGERY
CiteScore
6.30
自引率
0.00%
发文量
261
审稿时长
3 months
期刊介绍: Information not localized
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