Hasegawa T, Nakamura S, Manabe T, Mikawa Y
Department of Orthopedic Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Okayama, Japan.
Arch Orthop Trauma Surg. 2004 Apr;124(3):209-13. doi: 10.1007/s00402-003-0617-6. Epub 2004 Jan 31.
We reviewed the clinical outcomes of vascularized nerve grafts for the repair of large nerve gaps (longer than 20 cm) after severe trauma to an upper extremity. Six patients who underwent vascularized sural nerve grafting (five to the median nerve and one to the ulnar nerve) with a monitoring skin flap were evaluated. The length of the vascularized sural nerve grafts ranged from 20 to 30 cm, with a mean length of 23.3 cm. All but one of the monitoring skin flap grafts was successful. In those patients for whom the monitoring skin flap graft was successful, the mean static-2PD at the corresponding fingertip was 14.2 mm (range 10-20 mm). Evaluation of these patients with the Semmes-Weinstein test produced the following results: filament 6, two patients; filament 10, three patients. The results of this study show that vascularized sural nerve grafting should be considered as a clinical alternative for nerve reconstruction in patients with nerve defects longer than 20 cm.
我们回顾了用于修复上肢严重创伤后大神经缺损（长度超过20厘米）的带血管神经移植的临床结果。对6例行带血管腓肠神经移植（5例移植至正中神经，1例移植至尺神经）并带有监测皮瓣的患者进行了评估。带血管腓肠神经移植的长度为20至30厘米，平均长度为23.3厘米。除1例监测皮瓣移植外，其余均成功。在监测皮瓣移植成功的患者中，相应指尖的平均静态两点辨别觉为14.2毫米（范围为10 - 20毫米）。用Semmes-Weinstein测试对这些患者进行评估，结果如下：6号细丝，2例患者；10号细丝，3例患者。本研究结果表明，对于神经缺损长度超过20厘米的患者，带血管腓肠神经移植应被视为神经重建的一种临床替代方法。
