Li Qichao, Liu Zhangmin, Lu Junyue, Shao Wenchai, Feng Xiaobo
Department of Hand Surgery, Renqiu City People's Hospital, Renqiu Hebei, 062550,
Department of Hand Surgery, Renqiu City People's Hospital, Renqiu Hebei, 062550, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Aug 15;31(8):992-995. doi: 10.7507/1002-1892.201612105.
To investigate the effectiveness of transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion.
Between January 2007 and May 2015, 23 patients with thumb nerve avulsion were treated by transferring the ulnaris proper digital nerve of index finger and its dorsal branch. There were 17 males and 6 females with an average age of 32 years (range, 16-63 years). The injuries were caused by machine twist in 10 cases, electric saw in 8 cases, and sharp article prick in 5 cases. And thumb rotational avulsion amputation happened in 8 cases, thumb incomplete amputation in 2 cases, laceration of thumb palmaris with the thumb nerve avulsion of both sides in 13 caese (7 cases with tendon rupture). The time from injury to operation was 1.0-3.5 hours (mean, 2.2 hours).
All incisions healed by first intention. Ten cases of thumb reimplantation were successful. All the patients were followed up for 5 months to 2 years and 8 months, with an average of 1 year and 4 months. Two-point discrimination was 3-9 mm (mean, 6.8 mm). According to Society of Hand Surgery standard for the evaluation of upper part of the function, the sensory of the thumb was rated as S in 18 cases and S3+ in 5 cases; the sensory at donor sites recovered to S3. Conclusion Transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion is a simple and effective method to restore sensory function of the thumb pulp.
Transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion is a simple and effective method to restore sensory function of the thumb pulp.
探讨食指固有尺神经及其背支移位修复拇指神经撕脱伤的疗效。
2007年1月至2015年5月,采用食指固有尺神经及其背支移位治疗23例拇指神经撕脱伤患者。其中男17例,女6例,平均年龄32岁(16~63岁)。致伤原因:机器绞伤10例,电锯伤8例,锐器刺伤5例。拇指旋转撕脱性断指8例,拇指不全离断2例,拇指掌侧裂伤合并双侧拇指神经撕脱13例(其中肌腱断裂7例)。受伤至手术时间为1.0~3.5小时,平均2.2小时。
所有切口均一期愈合。10例拇指再植成功。所有患者随访5个月至2年8个月,平均1年4个月。两点辨别觉为3~9mm,平均6.8mm。按手外科协会上肢功能评定标准,拇指感觉:S4 18例,S3+ 5例;供区感觉恢复至S3。结论食指固有尺神经及其背支移位修复拇指神经撕脱伤是恢复拇指指腹感觉功能的一种简单有效的方法。
食指固有尺神经及其背支移位修复拇指神经撕脱伤是恢复拇指指腹感觉功能的一种简单有效的方法。