Imai H, Tajima T, Natsumi Y
Department of Orthopedic Surgery, Niigata University School of Medicine, Japan.
J Hand Surg Am. 1991 Jan;16(1):60-5. doi: 10.1016/s0363-5023(10)80014-0.
The effect of sensory reeducation was evaluated in a group of twenty-two adult patients who had a repair of a clean-cut median nerve at the wrist. These results were compared with the sensibility in a group of twenty-four adults with repair of clean-cut median nerve at the wrist who had never received sensory reeducation. The reeducation group were evaluated between one and two years from the time of their median nerve repair. The control patients were retrospectively evaluated between one and sixteen years after their nerve repair. The effect of reeducation on improving the paresthesias that accompany neural regeneration was also evaluated. Sensibility was determined by an object recognition test and by measurement of static and moving two-point discrimination. The results demonstrated that sensory reeducation significantly (p less than 0.01) diminished the severity of postoperative paresthesias. It also gave significantly better improvement in moving two-point discrimination than in static two-point discrimination within the timeframe evaluated (p less than 0.002). Excellent recovery of sensibility, as determined by ability to recognize nine or more objects out of twelve, was significantly greater (p less than 0.005) for the sensory reeducation group than at any time interval beginning after six months after nerve repair. It is concluded that a program of sensory reeducation after median nerve repair at the wrist in adults minimizes discomfort and improves sensibility in the postoperative period.
对一组22名成年患者进行了感觉再训练效果评估,这些患者接受了腕部正中神经锐器伤修复术。将这些结果与另一组24名成年患者的感觉功能进行比较,这组患者同样接受了腕部正中神经锐器伤修复术,但从未接受过感觉再训练。再训练组在正中神经修复后1至2年进行评估。对照组患者在神经修复后1至16年进行回顾性评估。还评估了再训练对改善神经再生伴随的感觉异常的效果。通过物体识别测试以及静态和动态两点辨别觉测量来确定感觉功能。结果表明,感觉再训练显著(p < 0.01)减轻了术后感觉异常的严重程度。在评估的时间范围内,动态两点辨别觉的改善也显著优于静态两点辨别觉(p < 0.002)。根据能够识别12个物体中的9个或更多物体来确定,感觉再训练组的感觉功能极佳恢复情况显著高于神经修复后6个月开始的任何时间间隔(p < 0.005)。结论是,成人腕部正中神经修复术后的感觉再训练计划可在术后减少不适并改善感觉功能。