抄録
We reviewed the results of elbow and shoulder functions using nerve transfer after brachial plexus injury. There were 21 patients with an average age of 26.9 (15-68) years. Total palsy was noted in 11 patients, and upper palsy in 10 patients. Twelve patients were treated by intercostal nerve transfer, and 5 were treated by Oberlin procedure to reconstruct elbow function. Shoulder function was reconstructed simultaneously in 3 of 5 patients treated by Oberlin procedure using spinal accessory nerve to suprascapular nerve transfer. Free muscle transfer following Doi's method was performed in 5 total palsy patients to reconstruct the elbow and finger functions simultaneously, and in 2 patients with upper palsy to reconstruct elbow flexion alone. Four patients who underwent free muscle transfer had previously received treatment, such as intercostal nerve transfer, but the results were poor.
The results of elbow function after Oberlin procedure and free muscle transfer were satisfactory (›grade 4 was achieved in all patients) in young patients while that of intercostal nerve transfer was unstable in our series. Useful shoulder function was reconstructed in all 3 patients after spinal accessory nerve to suprascapular nerve transfer.
