Herrera J T, Chávez C G, Sesma R V, Farías R C, Núñez A F
Hospital General de Puebla Dr. Eduardo Vázquez Navarro.
Acta Ortop Mex. 2010 Sep-Oct;24(5):291-7.
To assess the functional results of nerve reconstruction with autologous interfascicular nerve grafts in a thoracic limb.
From January 1999 to December 2006. Complete nerve injuries of the radial, median and ulnar nerves. Follow-up was at least 12 months.
age, nerve defect length, location, interval between the injury and the treatment, mechanism, injuries, and adjunctive treatments. The procedures were performed by the authors. Nine and 10-0 sutures were used. The Medical Research Council System (MRCS) scale was used for the functional measurement. The chi2 test was applied to variables and functional results.
43 patients, 48 nerves, mean age 26.7 years; 29 males and 14 females. Nineteen injuries occurred in the ulnar nerve (39.5%), 18 in the median nerve (37.5%) and 11 in the radial nerve (23%). Five patients had injury of the median and ulnar nerves. Twenty three injuries involved the wrist (53.4%), 7 the forearm (16.2%) and 12 the arm (27.9%). The mean time elapsed between the injury and the treatment was 42.09 days. The mean size of the nerve defect was 4.4 cm. The mean followup was 17.5 months. Forty two patients had associated injuries and 37 received adjunctive treatment. Motor function: Results were good in 15 patients (31.2%), fair in 21 (43.8%), poor in 10 (20.8%) and bad in 2 (4.2%). Sensory function: Results were good in 36 nerves (75%), fair in 4 (83%), poor in 6 (12.5%) and bad in 2 (4.2%).
The results were similar to those reported in the literature.
Good results were obtained in gaps < or = 5 cm, in cases without arterial injury and when the time to treatment did not exceed 40 days (p < 0.05). The age, the nerve and the site of injury were not influencing factors.
评估自体束间神经移植修复胸肢神经的功能效果。
1999年1月至2006年12月。桡神经、正中神经和尺神经完全性损伤。随访至少12个月。
年龄、神经缺损长度、部位、损伤与治疗间隔时间、损伤机制、合并损伤及辅助治疗。手术由作者完成。使用9-0和10-0缝线。采用医学研究委员会系统（MRCS）量表进行功能评估。对变量和功能结果应用卡方检验。
43例患者，48条神经，平均年龄26.7岁；男性29例，女性14例。尺神经损伤19例（39.5%），正中神经损伤18例（37.5%），桡神经损伤11例（23%）。5例患者正中神经和尺神经均损伤。23例损伤累及腕部（53.4%），7例累及前臂（16.2%），12例累及上臂（27.9%）。损伤与治疗的平均间隔时间为42.09天。神经缺损平均长度为4.4 cm。平均随访17.5个月。42例患者有合并损伤，37例接受辅助治疗。运动功能：15例患者结果为优（31.2%），21例为良（43.8%），10例为差（20.8%），2例为劣（4.2%）。感觉功能：36条神经结果为优（75%），4条为良（8.3%），6条为差（12.5%），2条为劣（4.2%）。
结果与文献报道相似。
在神经缺损≤5 cm、无动脉损伤且治疗时间不超过40天的病例中取得了良好效果（p<0.05）。年龄、神经及损伤部位不是影响因素。
