neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2023-25-1-95-102neurosurgery-1340Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWТранспозиция функционирующих мышц в комплексном лечении взрослых пациентов с повреждениями плечевого сплетения (обзор литературы)Transposition of functioning muscles in complex treatment of adult patients with injuries of the bracheric plexus (literature review)https://orcid.org/0000-0002-1560-6000НеведровА. В.NevedrovA. V.

129090 Москва, Б. Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090

https://orcid.org/0000-0001-7561-8209КелбанД. И.KelbanD. I.

129090 Москва, Б. Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090

https://orcid.org/0000-0003-4937-0400АлейниковаИ. Б.AleynikovaI. B. 

Ирина Борисовна Алейникова 

129090 Москва, Б. Сухаревская пл., 3

Irina Borisovna Aleynikova 

3 Bolshaya Sukharevskaya Sq., Moscow 129090

alejnikova_irina@mail.ruhttps://orcid.org/0000-0002-2954-6985ИвановП. А.IvanovP.  A.

129090 Москва, Б. Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090

https://orcid.org/0000-0003-3515-8329ГриньА. А.GrinA. A.

129090 Москва, Б. Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090

https://orcid.org/0000-0002-1538-0515СветловК. В.SvetlovK.  V.

129090 Москва, Б. Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090

ГБУЗ «НИИ скорой помощи им. Н. В. Склифосовского Департамента здравоохранения города Москвы»РоссияN.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare DepartmentRussian Federation20233003202325195102Copyright © Неведров А.В., Келбан Д.И., Алейникова И.Б., Иванов П.А., Гринь А.А., Светлов К.В., 20232023Неведров А.В., Келбан Д.И., Алейникова И.Б., Иванов П.А., Гринь А.А., Светлов К.В.Nevedrov A.V., Kelban D.I., Aleynikova I.B., Ivanov P.A., Grin A.A., Svetlov K.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1340Введение

Введение. Повреждения плечевого сплетения – один из самых тяжелых видов травм нервов верхней конечности, а варианты с отрывом корешков от спинного мозга представляют очень трудную для лечения категорию травм. Среди пациентов, получивших такие повреждения, весьма высока частота инвалидизации, поскольку удается достичь лишь частичного восстановления функции верхней конечности. В последнее время растет популярность метода транспозиции функционирующих мышц благодаря его надежности и относительно небольшим срокам восстановления функции.

Цель работы – анализ данных литературы по возможности применения метода транспозиции функционирующих мышц в комплексном лечении пострадавших с повреждениями плечевого сплетения.

Авторами осуществлен поиск в базах PubMed и РИНЦ за последние 25 лет по следующим ключевым словам: повреждения плечевого сплетения, транспозиция функционирующих мышц. В 23 наиболее релевантных работах, отобранных нами, проанализированы используемые для транспозиции мышцы, показания и сроки операций, результаты и осложнения, проведено сравнение с другими методами оперативного лечения повреждений плечевого сплетения. Анализ исследований показал, что транспозиция функционирующих мышц позволяет в большинстве случаев восстановить целевое движение до полезного уровня М3–М4 по шкале MRC, является более надежным методом и позволяет достичь лучших результатов, особенно у пациентов с тяжелыми и полными повреждениями плечевого сплетения. Важный недостаток операций по свободной пересадке тонкой мышцы бедра – риск тромбозов микроанастомозов, что требует детального предоперационного планирования и хорошей микрохирургической техники оперирующей бригады.

Заключение

Заключение. Свободную пересадку 2 функционирующих мышц в настоящее время можно считать методом выбора для восстановления движений верхней конечности у пациентов с полными повреждениями плечевого сплетения.

Introduction

Introduction. Injuries to the brachial plexus are one of the most severe types of injuries to the nerves of the upper limb, and variants with the separation of the roots from the spinal cord represent a very difficult category of injuries to treat. Among patients who have received such injuries, there is a very high incidence of disability, since it is possible to achieve only partial restoration of the function of the upper limb. Recently, the method of transposition of functioning muscles has been growing in popularity due to its reliability and relatively short recovery time of function.

The purpose of the work is to analyze the literature data on the possibility of using the method of transposition of functioning muscles in the complex treatment of victims with brachial plexus injuries.

The authors have searched PubMed and RSCI databases over the past 25 years for keywords: peripheral nerve damage, tendon transposition, transposition of functioning muscles, nerve injury, brachial plexus injury, spinal cord root avulsion. In the selected 23 most relevant papers, the muscles used for transposition, indications and timing of operations, results and complications were analyzed, compared with other methods of surgical treatment of brachial plexus injuries. The analysis of studies has shown that the transposition of functioning muscles allows in most cases to restore the target movement to the useful level of M3–M4 on the MRC scale, is a more reliable method and allows achieving better results, especially in patients with severe complete injuries of the brachial plexus. An important disadvantage of free hip thin muscle transplantation operations is the risk of microanastomosis thrombosis, which requires detailed preoperative planning and good microsurgical technique of the operating team.

Conclusion

Conclusion. Free transplantation of 2 functioning muscles is currently the method of choice for restoring upper limb movements in patients with complete brachial plexus injuries.

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The authors declare that there are no conflicts of interest present.