SURGICAL REPAIR OF THE AXILLARY NERVE - REPORT ON 37 CASES

被引:19
作者
ALNOT, JY
VALENTI, P
机构
[1] Service de Chirurgie Orthopédique et Traumatologique, Département de Chirurgie du Membre Supérieur, Hôpital Bichat, Paris Cedex 18, F-75877, 46, rue Henri Huchard
关键词
D O I
10.1007/BF00210524
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
The authors have reviewed the results of the operative repair of 37 injuries of the axillary nerve. In 25 patients only the axillary nerve was injured, in 8 the suprascapular nerve was also damaged and in a further 4 the musculocutaneous nerve had also sustained injury. There was an associated anterior dislocation of the shoulder in 10 patients and a fracture was present in 8. Eleven patients out of 25 had a nearly normal range of abduction in spite of paralysis of the deltoid muscle, and this accounted for delay in diagnosis. Operation was undertaken 8 months after injury using a combined anterior and posterior approach. In 34 patients disruption of the nerve had occured in relation to the quadrilateral space. In 32 cases nerve grafts were employed, in 2 direct suture and 1 underwent neurolysis. The results were good or very good in 23 out of the 25 direct repairs of isolated axillary lesions, and in all 4 patients with associated injury to the musculocutaneous nerve. Only 4 good results were obtained in the 8 patients who also had injuries to the suprascapular nerve. The results suggest that repair should be carried out early at between 3 and 6 months. E.M.G. studies are necessary before operation for proper assessment of nerve recovery.
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页码:7 / 11
页数:5
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共 10 条
[1]  
Alnot J.Y., Allieu Y., Bonnel F., Cadre N., Frot B., Huten D., Mansat M., Millesi H., Narakas A., Sedel L., Paralysie traumatique du plexus brachial de l'adulte. Symposium Société Française de Chirurgie Orthopédique et Traumatologique, Rev Chir Orthop, 63, pp. 17-25, (1977)
[2]  
Alnot J.Y., Jolly A., Les lésions du nerf circonflexe. A propos de 19 cas, Rev Chir Orthop, 69, pp. 539-546, (1983)
[3]  
Berry H., Bril V., Axillary nerve palegy following blunt trauma to the shoulder region: a clinical and electrophysiological review, J New, 45, pp. 1027-1032, (1982)
[4]  
Coene L.N., Axillary nerve lesions and associated injury, Thèse 1985, (1985)
[5]  
Coene L.N., Narakas A.O., Surgical management of axillary nerve lesions, isolated or combined with other infraclavicular nerve lesions. Peripheral nerve repair and regeneration, Liviana Press, 3, pp. 47-65, (1986)
[6]  
Comtet J.J., Auffray Y., Physiologie des muscles élévateurs de l'épaule, Rev Chir Orthop, 56, 2, pp. 105-107, (1970)
[7]  
Inman V., Saunders M., Abbot C., Observations on the function of the shoulder joint, J Bone Joint Surg, 26, pp. 1-30, (1944)
[8]  
Omer G.E., Evaluation d'une lésion nerveuse périphérique post-traumatique: les lésions traumatiques des nerfs périphériques, pp. 65-72, (1979)
[9]  
Petrucci F.S., Morelli A., Raimondi P.L., Axillary nerve injuries — 21 cases treated by graft and neurolysis, J Hand Surg, 7, pp. 271-278, (1982)
[10]  
Sedel L., Réparation du nerf circonflexe pour une voie d'abord inférieure, Rev Chir Orthop, 2, (1985)