상완형 상완신경총 손상에서 2개의 척골 신경속을 이용한 근피신경으로의 신경이전

초록

Purpose: The purpose of this study is to evaluate the restoration of elbow flexion power in patients to be operated in the neurotization of two anteromedial fascicles of ulnar nerve to musculocutaneous nerve. Materials and Methods: From August 1993 to March 1998, 5 patients of brachial plexus injury were treated with neurotization of two fascicles of ulnar nerve to musculocutaneous nerve. We evaluated the recovery of the biceps muscle power by the method of British Medical Research Council Grading System, and also measured grip power of hand, pinch power of 5th finger and two point discrimination of the little finger which is innervated by ulnar nerve in three months interval. Results: The recovery of elbow flexion was observed in four of those five patients between four and sixteen months after operation and at the latest follow-up, the biceps muscle strength was evaluated to M4 in two patients (4 kgf, 3.5 kgf each other), M3 in two patients and M1 in one patient. The grip and pinch strength were more improved than before the surgery. The two point discrimination was same as unaffected side. Conclusion: This operative method is recommendable because the recovery of elbow flexion was good and no notable impairment of hand function was observed.

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