Pamuk Çağdaş
Orthopedics and Traumatology Department, Private Silivri Anadolu Hospital, Istanbul, Turkey.
Ir J Med Sci. 2023 Oct;192(5):2235-2241. doi: 10.1007/s11845-022-03268-4. Epub 2023 Jan 4.
There are very few studies comparing patients with and without repair after digital nerve injury. It is still controversial whether digital nerve repair is necessary.
The aim of this study was to evaluate the long-term clinical outcomes of patients with unilateral isolated digital nerve injury who underwent surgical repair and those who did not.
Seventy-four patients with unilateral digital nerve injury were included in the study. Of these, the patients who underwent surgical repair were determined as group A (n = 42), the patients without repair as group B (n = 32), and the groups were divided into subgroups according to injury levels. Results were evaluated with a minimum follow-up of 24 months.
When the S2PD results were evaluated overall, it was found that those who had digital nerve repair (group A) had significantly better outcomes compared to those without repair (group B) (p = 0.012). When the subgroups were evaluated according to the injury localization, no significant difference was observed at the distal levels, while it was observed that the patients who underwent repair in the proximal levels showed significantly better results (p = 0.003, p = 0.012).
In this study, it was seen that there was no difference between the results of repair and non-repair of unilateral nerve injuries distal to the middle level of the middle phalanx, but repair is required in injuries proximal to this level.
比较指神经损伤后接受修复和未接受修复患者的研究非常少。指神经修复是否必要仍存在争议。
本研究的目的是评估接受手术修复和未接受手术修复的单侧孤立性指神经损伤患者的长期临床结局。
本研究纳入了74名单侧指神经损伤患者。其中,接受手术修复的患者被确定为A组(n = 42),未接受修复的患者为B组(n = 32),并根据损伤水平将两组进一步分为亚组。结果评估的最短随访时间为24个月。
总体评估S2PD结果时,发现接受指神经修复的患者(A组)比未接受修复的患者(B组)结局明显更好(p = 0.012)。根据损伤部位评估亚组时,在远端水平未观察到显著差异,而在近端水平接受修复的患者显示出明显更好的结果(p = 0.003,p = 0.012)。
在本研究中,可见在中节指骨中部水平远端的单侧神经损伤修复与未修复结果之间无差异,但在此水平近端的损伤需要进行修复。