评估关节弯曲患者将背阔肌转位至肩膀肱二头肌位置结果的神经生理学相关性
- 作者: Agranovich O.E.1, Savina M.V.1, Ivanov D.A.2, Boyko A.E.1, Blagoveshchenskiy Y.D.1,3
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隶属关系:
- H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
- Kazan State Medical University
- Higher School of Economics
- 期: 卷 8, 编号 2 (2020)
- 页面: 151-158
- 栏目: Original Study Article
- ##submission.dateSubmitted##: 10.04.2020
- ##submission.dateAccepted##: 21.05.2020
- ##submission.datePublished##: 01.07.2020
- URL: https://journals.eco-vector.com/turner/article/view/32591
- DOI: https://doi.org/10.17816/PTORS32591
- ID: 32591
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详细
论证:肘关节缺乏主动屈曲是关节弯曲患者的主要问题之一。在肘关节缺乏主动屈曲的情况下,自助选择是有限的,所以为了矫正这种情况,他们将自体肌肉移植物移到肩膀肱二头肌的位置。背阔肌最常用于此目的。
目的是确定评估关节弯曲患者将背阔肌转位至肩膀肱二头肌位置结果的神经生理学相关性。
材料与方法。从2011年到2018年,联邦政府预算机构H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery 俄罗斯联邦卫生部检查和治疗了30例关节弯曲的儿童,其通过单极移植背阔肌到上肢(共44条上肢)恢复了他们的肘关节主动屈曲。患者在手术前进行了检查,以及术后从1个月到96个月时间内(中位数—7个月,四分位数范围—2—24.5个月)。
对14例先天性多关节弯曲患者(23条上肢)术前后的临床、神经生理综合检查结果进行统计分析。
患儿手术时年龄为1至10岁,(平均年龄为4.89 ± 2.42岁)。
结果。我们的研究表明,手术时儿童的年龄对背阔肌共活化作用的变化没有显著影响。术后晚期背阔肌共活化作用指标的下降与移位肌力量的增加以及肘关节主动屈曲的改善有关,这证明了手术和随后康复的有效性。当背阔肌的共活化作用小于等于42%时,术后肌力达到4分。背阔肌的共活化作用指标并不取决于脊髓损伤的程度。然而,脊髓损伤程度影响肌肉强度:C6-C7和C6损伤水平的患者术后背阔肌强度最大,最小的是C5-C7。
结论。基于表面神经肌电图数据确定肌肉共活化作用指标,可用于评估关节弯曲患者将背阔肌转位至肩膀肱二头肌位置的结果,从而评估康复效果。背阔肌的共活化作用指标不超过42%,可作为确认手术良好功能结果的标准。
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作者简介
Olga Agranovich
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
编辑信件的主要联系方式.
Email: olga_agranovich@yahoo.com
SPIN 代码: 4393-3694
http://www.rosturner.ru/kl10.htm
MD, PhD, D.Sc., Supervisor of the Department of Arthrogryposis
俄罗斯联邦, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603Margarita Savina
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Email: drevma@yandex.ru
MD, PhD, Head of the Laboratory of Physiological and Biomechanical Research
俄罗斯联邦, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603Dmitry Ivanov
Kazan State Medical University
Email: i.dmitry1988@gmail.com
MD, assistant of the Department of Public Health and Health Organization
俄罗斯联邦, 49, Butlerov street, Kazan, 420012Alexey Boyko
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Email: ex.trol@mail.ru
MD, resident
俄罗斯联邦, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603Yevgeny Blagoveshchenskiy
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery; Higher School of Economics
Email: eblagovechensky@hse.ru
research associate at the Laboratory of Physiological and Biomechanical Research; PhD, senior research associate
俄罗斯联邦, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603; 20, Myasnitskaya str., Moscow, 101000参考
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