ABSTRACT

Objective

Brachial plexus injuries are among the most complex injuries of the peripheral nervous system and among the most devastating injuries overall. In complete lesions, functional priorities include the reinnervation of the musculocutaneous and axillary nerves for proximal functions restoration. Three major nerves – radial, median, and ulnar – and the corresponding muscles remain denervated, which results in subsequent muscle atrophy. This study was aimed at the evaluation of arm volumes in surgically treated patients with brachial plexus injuries, in correlation with the type of palsy, recovery and associated factors.

Methods

The study included 36 patients with brachial plexus injuries who were surgically treated in our institution over a 15-year-long period. The evaluation of arm and arm segments volumes was carried out using water displacement testing, based on the Archimedes principle.

Results

Statistically significant differences were noted between the operated arm and the healthy arm in all of the measured segments (hands, forearms and upper arms), as well as between the patients with complete and upper palsy, and in correlation with the shoulder abduction recovery.

Conclusions

Previous studies were mainly focused on the functional outcome and quality of life; although related to both, arm volumes in patients with brachial plexus injuries were not analyzed before. Significant differences between the operated arm and the healthy arm volumes, as well as between the various types of palsy, found in the present study should trigger further prospective research in relation to neurophysiology, useful functional recovery and quality of life.

中文翻译：

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手臂体积评估在臂丛神经创伤性损伤手术修复后功能结果和患者满意度中的作用。

摘要

客观的

臂丛神经损伤是周围神经系统最复杂的损伤之一，也是最具破坏性的损伤之一。在完全病变中，功能优先事项包括肌皮神经和腋神经的再支配，以恢复近端功能。三个主要神经——桡神经、正中神经和尺神经——以及相应的肌肉仍然没有神经支配，这会导致随后的肌肉萎缩。本研究旨在评估接受手术治疗的臂丛神经损伤患者的手臂体积与麻痹类型、恢复和相关因素的相关性。

方法

该研究包括 36 名臂丛神经损伤患者，他们在我们的机构中​​接受了长达 15 年的手术治疗。基于阿基米德原理，使用水置换测试对臂和臂段体积进行评估。

结果

在所有测量部位（手、前臂和上臂）以及完全麻痹和上肢麻痹患者之间，手术臂和健康臂之间均存在统计学显着差异，并与肩外展恢复相关。

结论

以前的研究主要集中在功能结果和生活质量上；尽管与两者有关，但之前并未分析臂丛神经损伤患者的手臂体积。在本研究中发现的手术手臂和健康手臂体积之间以及各种类型的麻痹之间的显着差异应该引发与神经生理学、有用的功能恢复和生活质量相关的进一步前瞻性研究。