Gual J S
J Hand Surg Am. 1983 May;8(3):289-96. doi: 10.1016/s0363-5023(83)80162-2.
Twenty-eight upper extremity nerves in 25 patients were repaired using an electrical nerve stimulator to identify major fascicles for their sensory and motor content. The proximal stump was searched for major sensory fascicles, as determined by the patient's verbal response, while using a general anesthesia "wake-up" technique. The distal stump was searched for major motor fascicles, judged by the observed twitch in the appropriate intrinsic muscles of the hand. Repair was usually by selective fascicle suture combined with epineurial suture. Identification of the separate digital nerve fascicles in the distal stump was not attempted. Ten median and five ulnar nerves were evaluated after 2 to 4 years. Median nerve repairs have shown satisfactory results, with thenar motor recovery ranging from 25% to 95% of normal in nine of 10 cases. Pure median nerve supply of the thenar muscles was confirmed by ulnar nerve block. The small ulnar nerve sample also shows encouraging results, but more end results are needed to substantiate the current impression.
在25例患者中，使用电神经刺激器修复了28条上肢神经，以识别其感觉和运动成分的主要束支。在全身麻醉“唤醒”技术下，根据患者的言语反应寻找近端残端的主要感觉束支。通过观察手部相应固有肌的抽搐来判断远端残端的主要运动束支。修复通常采用选择性束支缝合联合神经外膜缝合。未尝试识别远端残端中单独的指神经束支。对10条正中神经和5条尺神经进行了2至4年的评估。正中神经修复显示出满意的结果，10例中有9例的鱼际肌运动恢复达到正常的25%至95%。通过尺神经阻滞证实了鱼际肌由纯正中神经支配。少量的尺神经样本也显示出令人鼓舞的结果，但需要更多的最终结果来证实目前的印象。
