Ochi Kensuke, Horiuchi Yukio, Tazaki Kenichi, Takayama Shinichiro, Nakamura Toshiyasu, Sato Kazuki
Department of Orthopaedic Surgery, Kawasaki Municipal Kawasaki Hospital , 12-1 Shinkawa-dori, Kawasaki-ku, Kawasaki, Kanagawa, 210-0013 , Japan.
J Plast Surg Hand Surg. 2013 Dec;47(6):493-7. doi: 10.3109/2000656X.2013.787936. Epub 2013 Apr 18.
There are still no factors that predict the prognoses of patients with spontaneous posterior interosseous nerve palsies who are in an early phase of the illness. This paper reviewed 39 patients with this type of palsy. Seventeen patients who requested surgery for possible earlier recovery underwent interfascicular neurolysis because no signs of recovery were seen more than 3 months after onset. A Medical Research Council muscle power grade over 4 at their final visit was considered a good result, while a power less than grade 4 was considered a poor result. The clinical outcomes were significantly worse for the patients who had palsies with slow progressions (for more than 1 month) compared with those who had palsies with rapid progressions (completed within 1 month), regardless of their treatment. No significant difference was seen between the prognoses of patients with complete and incomplete palsies. We, therefore, recommend that interfascicular neurolysis is performed together with tendon transfer as the primary surgical procedures for patients with palsies with slow progression.
目前仍没有因素能够预测处于疾病早期的自发性骨间后神经麻痹患者的预后。本文回顾了39例此类麻痹患者。17例因可能更早恢复而要求手术的患者接受了束间神经松解术，因为发病3个月后仍未见恢复迹象。最后一次就诊时医学研究委员会肌力分级超过4级被认为是良好结果，而肌力低于4级则被认为是不良结果。无论治疗情况如何，进展缓慢（超过1个月）的麻痹患者的临床结局明显比进展迅速（在1个月内完成）的麻痹患者更差。完全性和不完全性麻痹患者的预后没有显著差异。因此，我们建议对于进展缓慢的麻痹患者，将束间神经松解术与肌腱转移术作为主要手术方法一起进行。
