改良式肩帶應用於臂神經叢上叢受傷：三病例報告

Modified Shoulder Sling For Upper Brachial Plexus Injury : 3 Cases Report

羅瑞寬(Sui-Food Lo) ； 梁秋萍(Chen-Peng Leong) ； 張瑞昆(Ruey-Knen Chang) ； 黃美涓(May-Kuen Wong)

《中華民國復健醫學會雜誌》 21期 (1993/12) Pp. 167-172

摘要

臂神經叢受傷是門診常見的問題。患者常併有上肢無力及肩關節脫臼。在臂神經叢上叢神經受傷的病患而言。上肢末端雖有肌力但卻不能善加利用，至為可惜。傳統式肩帶雖然可幫助矯正肩部脫臼。但患者仍無法好好利用較好之腕手功能。故此吾人提出改良式肩帶。既可有良好的肩部脫臼復位功能又能讓腕手發揮部份功能以從事日常活動。
本報告之改良式肩帶設計分兩部分（一）肩部以皮革固定並在前方加一楔狀海綿作往後方之壓迫。（二）遠端為前臂固定副木，兩者以一跨越對側肩部及垂直吊帶連接，使患側在肘關節屈曲90°時前臂能向各方向活動。三位患者使用該肩帶並經訓練後，患側均可作為日常生活活動之輔助手。

關鍵字

臂神經叢受傷 ； 肩吊帶

並列摘要

Brachiai plexus injury is commonly seen in rehabilitation clinic. Nerve transplantation and reconstruction surgery cannot improve the function of upper extremity immediately. They need physical and occupational therapy. Shoulder subluxation, pain, functional deficits are common sequelae of these injuries.
In the past, shoulder sling had been used to correct shoulder subluxation. However traditional type of shoulder sling does not allow distal wrist and hand to function properly and poor reduction of shoulder subluxation.
We designed a modified shoulder sling which consist of a leather belt with a wedge shaped spongy for backward compression and a forearm splint, they connected together by one shoulder crossing belt and two vertical belts. We applied it on 3 patients with traumatic upper brachial plexus injury. These 3 patients all had anterior shoulder subluxation and greater proximal than distal upper extremity weakness. We found that they all had good reduction of subluxation after use of this modified shoulder sling in x-ray study and can make good use of distal wrist and hand. Their affected side can function properly as an asistant hand.