Patterson Ryan W, Van Niel Monica, Shimko Patty, Pace Carter, Seitz William H
Cleveland Clinic, Cleveland, OH, USA.
J Hand Surg Am. 2010 Jan;35(1):52-6. doi: 10.1016/j.jhsa.2009.10.014.
The posterior interosseous sensory nerve innervates the dorsal capsule of the wrist, which may provide nociceptive and proprioceptive sensation. Posterior interosseous sensory neurectomy (PISN) is commonly used as a primary or adjunctive procedure to provide wrist analgesia for a variety of wrist conditions. Currently, there is little information in the literature regarding the proprioceptive role of the posterior interosseous sensory nerve and the resultant effects of PISN on wrist proprioception. The purpose of our investigation was to examine the effect of PISN on wrist proprioception.
For 23 consecutive patients who had posterior interosseous sensory neurectomy, proprioception of their surgical wrists was compared to their nonsurgical wrists as well as to the normal wrists of 23 healthy volunteers. Using a custom testing device, wooden dowels were used to set subjects' wrists at specific angles within the testing jig, and then subjects were asked to mimic the position with their other hand at the following angles: neutral (0 degrees ), flexion (20 degrees , 40 degrees , 60 degrees ), extension (20 degrees , 40 degrees , 60 degrees ), 10 degrees of radial deviation, and 10 degrees of ulnar deviation. The following statistical comparisons were made:(1) patients' surgical versus controls' assessed wrists and(2) patients' surgical wrists versus patients' nonsurgical wrists.
There were no statistically significant differences in wrist proprioception except in 40 degrees of extension with more accurate estimations by surgical wrists when compared to control wrists.
Posterior interosseous sensory neurectomy does not appear to be associated with decreased proprioception of the wrist as measured by a custom testing device.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
骨间后感觉神经支配腕关节的背侧关节囊，可能提供伤害性和本体感觉。骨间后感觉神经切除术（PISN）通常作为主要或辅助手术，用于为各种腕部疾病提供腕部镇痛。目前，关于骨间后感觉神经的本体感觉作用以及PISN对腕部本体感觉的最终影响，文献中几乎没有相关信息。我们研究的目的是探讨PISN对腕部本体感觉的影响。
对连续23例行骨间后感觉神经切除术的患者，将其手术侧腕部的本体感觉与非手术侧腕部以及23名健康志愿者的正常腕部进行比较。使用定制测试装置，用木销将受试者的腕部在测试夹具内设定为特定角度，然后要求受试者用另一只手模仿以下角度的位置：中立位（0度）、屈曲（20度、40度、60度）、伸展（20度、40度、60度）、桡偏10度和尺偏10度。进行了以下统计比较：（1）患者手术侧腕部与对照组评估的腕部；（2）患者手术侧腕部与患者非手术侧腕部。
除了在伸展40度时，与对照腕部相比手术侧腕部的估计更准确外，腕部本体感觉没有统计学上的显著差异。
根据定制测试装置测量，骨间后感觉神经切除术似乎与腕部本体感觉降低无关。
研究类型/证据水平：治疗性IV级。
