Henry F P, Farkhad R I, Butt F S, O'Shaughnessy M, O'Sullivan S T
Department of Plastic, Reconstructive and Hand Surgery, Cork University Hospital, Wilton, Cork, Ireland.
J Hand Surg Eur Vol. 2012 Jun;37(5):422-6. doi: 10.1177/1753193411431208. Epub 2011 Dec 6.
Post-operative immobilisation following isolated digital nerve repair remains a controversial issue amongst the microsurgical community. Protocols differ from unit to unit and even, as evidenced in our unit, may differ from consultant to consultant. We undertook a retrospective review of 46 patients who underwent isolated digital nerve repair over a 6-month period. Follow-up ranged from 6 to 18 months. Twenty-four were managed with protected active mobilisation over a 4-week period while 22 were immobilised over the same period. Outcomes such as return to work, cold intolerance, two-point discrimination and temperature differentiation were used as indicators of clinical recovery. Our results showed that there was no significant difference noted in either clinical assessment of recovery or return to work following either post-operative protocol, suggesting that either regime may be adopted, tailored to the patient's needs and resources of the unit.
在显微外科领域,单纯指神经修复术后的固定仍然是一个有争议的问题。各科室的方案不尽相同,甚至在我们科室,不同的会诊医生之间也可能存在差异。我们对46例在6个月内接受单纯指神经修复的患者进行了回顾性研究。随访时间为6至18个月。其中24例患者在4周内进行了保护性主动活动,而另外22例患者在同一时期进行了固定。诸如恢复工作情况、冷不耐受、两点辨别觉和温度辨别等结果被用作临床恢复的指标。我们的结果表明,两种术后方案在恢复的临床评估或恢复工作方面均未发现显著差异,这表明可以根据患者的需求和科室资源采用任何一种方案。