■肘部伸展的手术重建可以帮助由于脊髓损伤而患有四肢瘫痪和三头肌瘫痪的患者恢复功能。已经描述了后三角肌到三头肌腱的转移和将腋下神经的分支转移到radial神经的三头肌运动分支的转移。本系统综述旨在回顾这两所手术学校在结果和并发症方面的最新证据。
■使用MEDLINE(1974-2023)和EMBASE(1946-2023)数据库进行了系统评价。关键词术语“弯头延伸”,\"\"三头肌,\"\"三角形,“神经转移”,“\”脊髓损伤,\"\"四肢瘫痪,\"\"四肢瘫痪,在最初的搜索中使用了“”和“四肢瘫痪”,补充了手动搜索检索文章的参考书目。
■20项研究符合我们的纳入标准,有14项研究(229条肢体)关于后三角肌到三头肌腱转移,5项研究(23条肢体)关于腋窝至桡骨神经转移,1项联合转移研究(1条肢体)。对于肌腱转移组,大多数研究报告的肱三头肌功率中位数为3级,达到反重力的失败百分比范围很广(0%~87.5%).常见的并发症包括肌肉肌腱单元的逐渐伸展,肌腱断裂转移,肘挛缩,和感染。对于神经转移组,大多数研究还报告了肱三头肌功率中位数达到3级.没有报告的并发症或供体肩展或外部旋转的功能丧失。
■在四肢瘫痪中将腋下神经分支转移到the神经的三头肌运动分支显示出有希望的结果,与传统肌腱转移相比,肱三头肌肌力相当,并发症发生率低。
■系统评价III。
UNASSIGNED: Surgical reconstruction of elbow extension can help restore function in patients with tetraplegia and triceps paralysis because of spinal cord injury. Both posterior deltoid-to-triceps tendon transfer and transfer of the branch of the axillary nerve to the triceps motor branch of the radial nerve have been described for triceps reanimation. This systematic review aimed at reviewing current evidence in the two schools of surgery in terms of their outcome and complication profile.
UNASSIGNED: A systematic review was conducted using MEDLINE (1974-2023) and EMBASE (1946-2023) databases. The keyword terms \"elbow extension,\" \"triceps,\" \"deltoid,\" \"nerve transfer,\" \"spinal cord injury,\" \"tetraplegia,\" \"quadriplegia,\" and \"tetraplegic\" were used in the initial search, which was supplemented with manual searches of the bibliographies of retrieved articles.
UNASSIGNED: Twenty studies met our inclusion criteria, with 14 studies (229 limbs) on posterior deltoid-to-triceps tendon transfer, 5 studies (23 limbs) on axillary to radial nerve transfer, and 1 study (1 limb) on combined transfer. For the tendon transfer group, the majority of studies reported a median triceps power of grade 3, with a wide range of failure percentage to reach antigravity (0% to 87.5%). Common complications included gradual stretching of the musculotendinous unit, rupture of the tendon transferred, elbow contracture, and infection. For the nerve transfer group, the majority of studies also reported a median triceps power reaching grade 3. There were no reported complications or loss of power in donor action of shoulder abduction or external rotation.
UNASSIGNED: Transfer of the axillary nerve branch to the triceps motor branch of the radial nerve in tetraplegia shows promising results, with comparable triceps muscle power compared to traditional tendon transfer and a low incidence of complication.
UNASSIGNED: Systematic Review III.