Thorsén Frida, Rosberg Hans-Eric, Steen Carlsson Katarina, Dahlin Lars B
Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden.
J Plast Surg Hand Surg. 2012 Sep;46(3-4):184-90. doi: 10.3109/2000656X.2012.676554. Epub 2012 Jun 11.
Epidemiology, results of treatment, impact on activity of daily living (ADL), and costs for treatment of digital nerve injuries have not been considered consistently. Case notes of patients of 0-99 years of age living in Malmö municipality, Sweden, who presented with a digital nerve injury and were referred to the Department of Hand Surgery in 1995-2005 were analysed retrospectively. The incidence was 6.2/100 000 inhabitants and year. Most commonly men (75%; median age 29 years) were injured. Isolated nerve injuries and concomitant tendon injuries were equally common. The direct costs (hospital stay, operation, outpatient visits, visits to a nurse and/or a hand therapist) for a concomitant tendon injury was almost double compared with an isolated digital nerve injury (6136 EUR [range, 744-29 689 EUR] vs 2653 EUR [range, 468-6949 EUR]). More than 50% of the patients who worked were injured at work and 79% lost time from work (median 59 days [range 3-337]). Permanent nerve dysfunction for the individual patient with ADL problems and subjective complaints of fumbleness, cold sensitivity, and pain occur in the patients despite surgery. It is concluded that digital nerve injuries, often considered as a minor injury and that affect young people at productive age, cause costs, and disability. Focus should be directed against prevention of the injury and to improve nerve regeneration from different aspects.
数字神经损伤的流行病学、治疗结果、对日常生活活动(ADL)的影响以及治疗费用一直未得到统一考量。对1995年至2005年间居住在瑞典马尔默市、患有数字神经损伤并被转诊至手外科的0至99岁患者的病历进行了回顾性分析。发病率为每10万居民每年6.2例。受伤者以男性居多(75%;中位年龄29岁)。孤立性神经损伤和合并肌腱损伤的情况同样常见。合并肌腱损伤的直接费用(住院、手术、门诊就诊、看护士和/或手治疗师)几乎是孤立性数字神经损伤的两倍(6136欧元[范围744 - 29689欧元]对2653欧元[范围468 - 6949欧元])。超过50%的在职患者在工作时受伤,79%的患者误工(中位误工时间59天[范围3 - 337天])。尽管进行了手术,但仍有个别患者出现永久性神经功能障碍,伴有ADL问题以及笨拙、冷敏感和疼痛等主观症状。结论是,数字神经损伤常被视为轻伤,却影响处于生产年龄的年轻人,会导致费用增加和残疾。应着重从不同方面预防损伤并促进神经再生。