Carey-Ewend Abigail G, Goldfarb Jake H, Randall Zachary D, Brogan David M, Dy Christopher J
Washington University School of Medicine, St Louis, Missouri.
Department of Orthopaedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
J Hand Surg Glob Online. 2025 Jan 9;7(2):192-195. doi: 10.1016/j.jhsg.2024.12.001. eCollection 2025 Mar.
The manner in which outcomes are reported after peripheral nerve injury (PNI) varies tremendously and often centers on surgeon-manual muscle testing. The purpose of our systematic review was to quantify the use of outcome measures after PNI in the contemporary literature (published in 2008 and beyond) and to evaluate which domains of recovery are assessed most frequently.
With the assistance of a medical librarian, we performed a systematic review of the literature published in or after 2008 (to represent the last 15 years) for patients with upper-extremity PNI. We excluded articles with <5 participants, minors, brachial plexus or digital nerve injuries, compressive neuropathies, or <6 months of follow-up. Data were extracted to identify which outcome measures were used in each study, categorizing the outcome measures under the domains of motor, sensory, function, and pain.
Of the 4 outcome domains (pain, motor, sensory, and function), motor was reported the most frequently, followed by function. Within the motor category, more than two-thirds of the studies used manual muscle testing for assessment. Half of the articles reported outcomes in 2 of the 4 assessed domains. Pain was the least assessed domain, reported in 11 of 68 articles.
While there has been incorporation of functional outcomes, the majority of the literature in the last 15 years remains focused on surgeon-reported muscle testing and does not adequately reflect the multiple domains affected by PNI. Pain is the least frequently reported domain, despite being an issue that frequently vexes PNI patients.
There is a need for clinicians and researchers to agree upon a common set of outcome measures for PNI that (A) encompass perspectives of clinicians and patients and (B) reflect multiple domains affected by PNI. This will improve the quality of outcome reporting and facilitate future comparative effectiveness studies.
周围神经损伤（PNI）后结果报告的方式差异极大，且通常以外科医生的徒手肌力测试为核心。我们进行系统评价的目的是量化当代文献（2008年及以后发表）中PNI后结局指标的使用情况，并评估最常评估的恢复领域。
在医学图书馆员的协助下，我们对2008年或之后发表的上肢PNI患者的文献进行了系统评价。我们排除了参与者少于5名、未成年人、臂丛或指神经损伤、压迫性神经病或随访时间少于6个月的文章。提取数据以确定每项研究中使用了哪些结局指标，并将结局指标归类为运动、感觉、功能和疼痛领域。
在4个结局领域（疼痛、运动、感觉和功能）中，运动领域的报告最为频繁，其次是功能领域。在运动类别中，超过三分之二的研究使用徒手肌力测试进行评估。一半的文章在4个评估领域中的2个领域报告了结果。疼痛是评估最少的领域，68篇文章中有11篇进行了报告。
虽然已经纳入了功能结局，但过去15年的大多数文献仍集中在外科医生报告的肌肉测试上，没有充分反映PNI所影响的多个领域。尽管疼痛是一个经常困扰PNI患者的问题，但它是报告最少的领域。
临床医生和研究人员需要就一套适用于PNI的通用结局指标达成共识，这些指标应（A）涵盖临床医生和患者的观点，（B）反映PNI所影响的多个领域。这将提高结局报告的质量，并促进未来的比较疗效研究。
