To Treat Root Avulsion in Brachial Plexus with Femoral Nerves
GU Yu dong, CHENG Xiao min, CHEN De song, et al. Dept. of Hand Surgery, Huashan Hospital, Shanghai Medical University, Shanghai 200040
Aim To observe the protective effect of femoral nerves transferred to the muscular branches of the thenar and hypothenar muscles on the hand intrinsic muscles. Methods Femoral nerve branches covered with a pedicle groin skin tube were transferred to the muscular branches of the thenar and hypothenar muscles on seven cases with brachial plexus root avulsion from May 1989 to October 1991. When the regeneration of the median and ulnar nerves was found to reach as far as the wrist level, the femoral nerve was moved away, and then the muscular branches of the thenar and hypothenar muscles were made to anastomose with the regenerated median and ulnar nerves. All the cases were followed up for more than 6 years. Results Six months after the femoral nerve transfer, the muscle power of the interosseous muscle and adductor pollicis reached MRC3, while that of abductor pollicis brevis reached MRC1￣2. Five cases underwent the second stage transfer. Four to five years' following up revealed that the muscle power of the interosseous muscle and adductor pollicis was M 2 in one case, M 1 in 2 cases and M 0 in 2 cases. At the donar area, the muscle power of the quadriceps femoris reduced to M 3～4 within one month after the femoral nerve transfer, and recovered to normal in three months. Conclusions Femoral nerve transfer to the muscular branches of the thenar and hypothenar muscles has some protective effects on the hand intrinsic muscles. The outcome of the second stage however is not satisfactory.
【CateGory Index】： R651.3