Georgoulis A, Hertel P
Abteilung für Unfallchirurgie, Universitätsklinikum Rudolf Virchow, Freien Universität Berlin.
Unfallchirurg. 1991 Mar;94(3):139-43.
Traumatic lesion of the deep branch of the radial nerve (posterior interosseous nerve) causes paralysis of the finger and thumb extension while wrist extension is maintained. There is no sensory disturbance. The lesion can be caused by knife injury, by Monteggia lesions and iatrogenically by procedures at the proximal radius. Traumatic disconnection of the posterior interosseous nerve is a good indication for early surgical exploration of the nerve; microsurgical reconstruction should then be carried out. When nerve repair has not been done or has been unsuccessful, finger and thumb extension can be achieved by various methods of tendon transfer. No transfer is necessary for the wrist. In two cases with fresh discission of the deep branch of the radial nerve (one after knife injury and one due to plate osteosynthesis of the radius) a microsurgical reconstruction was done. In two other cases with an old lesion after procedures on the proximal radius and unsuccessful nerve reconstruction a tendon transfer was done. In the two cases of acute microsurgical intervention the recovery was complete. In the two cases of tendon transfer good restoration of the finger and thumb extension was achieved.
桡神经深支(骨间后神经)创伤性损伤会导致手指和拇指伸展功能麻痹,但腕部伸展功能仍可保留。无感觉障碍。该损伤可由刀伤、孟氏骨折以及桡骨近端手术的医源性因素引起。骨间后神经创伤性离断是早期进行神经手术探查的良好指征;随后应进行显微外科重建。当未进行神经修复或修复失败时,可通过多种肌腱转移方法实现手指和拇指的伸展。腕部无需进行转移。在两例桡神经深支新鲜离断的病例中(一例为刀伤后,另一例为桡骨钢板内固定术后),进行了显微外科重建。另外两例在桡骨近端手术后出现陈旧性损伤且神经重建失败的病例,进行了肌腱转移。在急性显微外科干预的两例病例中,恢复完全。在肌腱转移的两例病例中,手指和拇指伸展功能得到了良好恢复。