Video-assisted thoracoscopic surgery (VATS) aided full-length phrenic nerve transfer for restoration of elbow flexion.

IF 1.3 4区医学 Q3 ORTHOPEDICS Journal of Orthopaedic Surgery Pub Date : 2023-05-01 DOI:10.1177/10225536231180330

Jayaletchumi Gunasagaran, Nuraliza Ab Wahab, Saw Sian Khoo, Shams Amir Shamsul, Sachin Shivdas, Shahrul Hashim, Tunku Sara Ahmad

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Abstract

Background: In complete brachial plexus injury, phrenic nerve (PN) is frequently used in neurotization for elbow flexion restoration. The advancement in video-assisted thoracoscopic surgery (VATS) allows full-length PN dissection intrathoracically for direct coaptation to recipient without nerve graft.

Purpose: We report our experience in improving the surgical technique and its outcome.

Methods: Seven patients underwent PN dissection via VATS and full-length transfer to musculocutaneous nerve (MCN) or motor branch of biceps (MBB) from June 2015 to June 2018. Comparisons were made with similar group of patients who underwent conventional PN transfer.

Results: Mean age of patients was 21.9 years. All were males involved in motorcycle accidents who sustained complete brachial plexus injury. We found the elbow flexion recovery were earlier in full-length PN transfer. However, there was no statistically significant difference in elbow flexion strength at 3 years post-surgery.

Conclusion: We propose full-length PN transfer for restoration of elbow flexion in patients with delayed presentation.

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电视胸腔镜手术（VATS）辅助全长膈神经移植恢复肘关节屈曲。

背景：在完全性臂丛神经损伤中，膈神经（PN）经常用于肘关节屈曲恢复的神经化。电视胸腔镜手术（VATS）的进步允许在没有神经移植的情况下在胸腔内进行全长PN剥离，直接接合受体。目的：我们报告我们在改进手术技术及其结果方面的经验。方法：2015年6月至2018年6月，7名患者通过VATS进行PN剥离，并全身转移至肌肉皮神经（MCN）或二头肌运动支（MBB）。将其与接受常规PN转移的类似患者组进行比较。结果：患者平均年龄21.9岁，均为摩托车事故中臂丛神经完全损伤的男性。我们发现，在全长PN转移中，肘关节屈曲恢复较早。然而，术后3年的屈肘强度没有统计学上的显著差异。结论：我们建议对延迟表现的患者进行全长PN转移以恢复屈肘。

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

Journal of Orthopaedic Surgery ORTHOPEDICS-SURGERY

CiteScore

3.10

自引率

0.00%

发文量

审稿时长

13 weeks

期刊介绍： Journal of Orthopaedic Surgery is an open access peer-reviewed journal publishing original reviews and research articles on all aspects of orthopaedic surgery. It is the official journal of the Asia Pacific Orthopaedic Association. The journal welcomes and will publish materials of a diverse nature, from basic science research to clinical trials and surgical techniques. The journal encourages contributions from all parts of the world, but special emphasis is given to research of particular relevance to the Asia Pacific region.