摘要

Abstract: The radial nerve is the most frequently injured nerve in the upper extremity. Numerous options in treatment have been described for radial nerve injury, such as neurolysis, nerve grafts, or tendon transfers. Currently, new treatment options are arising, such as platelet-rich plasma (PRP), an autologous product with proved therapeutic effect for various musculoskeletal disorders. We hypothesized that this treatment is a promising alternative for this type of nerve pathology. The patient was a healthy 27-year-old man who suffered a deep and long cut in the distal anterolateral region of the right arm. Forty-eight hours after injury, an end-to-end suture was performed without a microscope. Three months after the surgery, an electromyogram (EMG) showed right radial nerve neurotmesis with no tendency to reinnervation. Four months after the trauma, serial intraneural infiltrations of PRP were conducted using ultrasound guidance. The therapeutic effect was assessed by manual muscle testing and by EMG. Fourteen months after the injury and 11 months after the first PRP injection, functional recovery was achieved. The EMG showed a complete reinnervation of the musculature of the radial nerve dependent. The patient remains satisfied with the result and he is able to practice his profession. Conclusions: PRP infiltrations have the potential to enhance the healing process of radial nerve palsy. This case report demonstrates the therapeutic potential of this technology for traumatic peripheral nerve palsy, as well as the apt utility of US-guided PRP injections.

译文

摘要:桡神经是上肢最常受损的神经。已经描述了治疗桡神经损伤的许多治疗选择,例如神经松解,神经移植或肌腱转移。目前,出现了新的治疗选择,例如富含血小板的血浆(PRP),一种对各种肌肉骨骼疾病具有证明的治疗效果的自体产品。我们假设这种治疗方法是这种神经病理学的一种有前景的替代方法。该患者是一名健康的27岁男性,他在右臂远端前外侧区域进行了深切长切。伤后48小时,在没有显微镜的情况下进行端对端缝合。手术后3个月,肌电图(EMG)显示右桡神经神经断裂,无再神经支配倾向。创伤后4个月,使用超声引导进行PRP的连续神经内浸润。通过手动肌肉测试和EMG评估治疗效果。损伤后14个月和第一次PRP注射后11个月,实现了功能恢复。肌电图显示桡神经依赖的肌肉组织的完全神经再支配。患者对结果仍然满意,并且他能够练习他的职业。结论:PRP浸润有可能增强桡神经麻痹的愈合过程。本病例报告展示了该技术对创伤性周围神经麻痹的治疗潜力,以及美国指导的PRP注射的适用性。

Radial Nerve Palsy

神经 麻痹 疾病
概述  :  

桡神经发自臂丛后束,由C5~T1的神经根纤维组成,其运动支支配肱三头肌、旋后肌、肘肌、肱桡肌、桡侧腕长、短伸肌、尺侧腕伸肌、指总伸肌、示指和小指固有伸肌、拇长展肌和拇长、短伸肌,主要功能是伸肘、伸腕及伸指;感觉支分布于上臂、前臂背侧及手背、手指近端背面桡侧半。病因桡神经是臂丛神经中最易受损伤的一支,病因甚多。腋部或上肢受压、感染、肩关节脱臼、肱、桡骨骨折、上肢贯通伤、铅、乙醇中毒、手术时上臂长时间过度外展或新生儿脐带绕上臂均可造成桡神经受损。临床表现①高位损伤在腋下桡神经发出胧三头肌分支以上

radial     英 [ˈreɪdiəl]   美 [ˈreɪdiəl]

          adj. 放射状的;辐射状的 

同根词      irradiate v.发光;(光)漫射

radial adj. 放射的;半径的

radiance n. 发光;喜悦

radiant adj. 发光的

radiate v. 发出(光或热);流露

radiation n. 辐射;辐射能

          The method to analyze the pressure gradient with mean radial velocity isused. 本文提出了利用平均径向速速分析压力梯度的方法。

 

nerve 英 [nɜːv]  美 [nɝv] 

             n. 神经;勇气;[植] 叶脉  vt. 鼓起勇气

同根词   nervous adj. 神经的;紧张不安的;强健有力的  

nervy adj. 有勇气的;易激动的;紧张不安的

nervously adv.神经质地;焦急地;提心吊胆地 

nervily adv.大胆地;强壮地;神经过敏地

nervousness n.神经质;[心理] 神经过敏;紧张不安  

nervure n.叶脉;[昆] 翅脉

           I have the nerve to do it !  我有勇气去做这件事情。

 

palsy 英 ['pɔːlzɪ; 'pɒl-]  美 ['pɔlzi] 

            n. 麻痹,麻痹状态;中风 vt. 麻痹;使瘫痪

同根词      palsied adj.中风的;颤抖的 

palsied v.瘫痪;麻痹(palsy的过去式)

          The incidence rate of conscious disturbance and death increase in patients with gaze palsy. 伴有凝视麻痹的患者,意识障碍和死亡的发生率增高。

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