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尺神经和正中神经损伤一期显微外科修复后的长期结果。常见评分系统的比较。

Long-term results after primary microsurgical repair of ulnar and median nerve injuries. A comparison of common score systems.

作者信息

Vordemvenne Thomas, Langer Martin, Ochman Sabine, Raschke Michael, Schult Marc

机构信息

Department of Trauma and Hand Surgery, University Hospital of Münster, Waldeyerstr. 1, 48149 Münster, Germany.

出版信息

Clin Neurol Neurosurg. 2007 Apr;109(3):263-71. doi: 10.1016/j.clineuro.2006.11.006. Epub 2006 Dec 18.

Abstract

OBJECTIVE

The aim of this retrospective study was to analyze the long-term results of primary repair of median and ulnar nerve lesions. Clinical influence factors for nerve reconstruction were investigated. Furthermore, current score systems were inquired and evaluated on their effectiveness to illustrate the success of repair.

PATIENTS AND METHOD

Sixty-five patients with 71 lesions of the median and ulnar nerve were assessed on average 8.2 years after reconstruction. The results were classified according to the DASH (disability of arm, shoulder, and hand) Score, the Rosen's hand protocol and the Highet Scale.

RESULTS

On average the patients regained 70% of their original hand function (evaluated by Rosen Score: median nerve 2.2/for ulnar nerve 1.92 out of 3.0). Although we noticed inferior motor recovery in ulnar nerve lesions, no significant differences between the overall results of both nerves were observed. Neither accompanying artery and flexor tendon injuries nor the suture technique influenced the recovery. The age of the patient was confirmed as an important influence factor. The results of the DASH Score, Rosen Score and Highet Score correlated significantly.

CONCLUSION

For a sufficient outcome measurement we underline the importance of evaluation of patient's estimation of their impact on their activities of daily living. For this a combination of the functional Rosen Score and the DASH Score is suggested.

摘要

目的

本回顾性研究旨在分析正中神经和尺神经损伤一期修复的长期结果。研究神经重建的临床影响因素。此外,对当前的评分系统进行调查并评估其说明修复成功的有效性。

患者与方法

对65例正中神经和尺神经损伤71处的患者在重建后平均8.2年进行评估。结果根据上肢、肩部和手部功能障碍评分(DASH评分)、罗森手部评估方案和希格特量表进行分类。

结果

患者平均恢复了其原始手部功能的70%(根据罗森评分评估:正中神经为2.2/满分3.0,尺神经为1.92/满分3.0)。虽然我们注意到尺神经损伤时运动恢复较差,但两条神经的总体结果之间未观察到显著差异。伴发的动脉和屈肌腱损伤以及缝合技术均未影响恢复情况。患者年龄被确认为一个重要的影响因素。DASH评分、罗森评分和希格特评分的结果显著相关。

结论

为了进行充分的结果测量,我们强调评估患者对其日常生活活动影响的估计的重要性。为此,建议将功能性罗森评分和DASH评分结合使用。

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