Tadjalli H E, McIntyre F H, Dolynchuk K N, Murray K A
Division of Plastic Surgery, Baylor College of Medicine, Houston, TX, USA.
Ann Plast Surg. 1995 Jul;35(1):32-5. doi: 10.1097/00000637-199507000-00007.
This study was conducted to determine how testing of nerve repair using nerve isolation techniques compares with standard testing. Nerve isolation consisted of double-gloving, leaving the study finger free, and administering local anesthetic blocks to all other sensory contributions in the exposed digit. Ten patients with 13 single digital nerve repairs of equally severe injuries were studied at a mean of 41 months postoperatively. Standardized tests yielded an excellent result in 77% for static two-point discrimination (S2pd), 85% for moving two-point discrimination (M2pd), and 46.2% for Semmes-Weinstein monofilaments (SWMF). The same studies combined with nerve isolation yielded an excellent result in only 43% for S2pd, 43% for M2pd, and 0% for SWMF. These results indicate a statistically significant difference and the importance of crossover innervation from intact nerves in the long-term result of digital nerve repair. Nerve isolation study techniques are an important adjunct in assessing the outcome of nerve repair and are the only method of evaluating the true end result of nerve regeneration following neurorrhaphy.
本研究旨在确定使用神经隔离技术对神经修复进行检测与标准检测相比的情况。神经隔离包括戴双层手套、使研究手指保持自由状态，以及对暴露手指的所有其他感觉传入进行局部麻醉阻滞。对10例患者的13处同等严重损伤的单指神经修复进行了研究，术后平均随访41个月。标准化测试中，静态两点辨别觉（S2pd）的优良率为77%，动态两点辨别觉（M2pd）为85%，Semmes-Weinstein单丝试验（SWMF）为46.2%。同样的研究结合神经隔离后，S2pd的优良率仅为43%，M2pd为43%，SWMF为0%。这些结果表明存在统计学上的显著差异，以及完整神经的交叉神经支配在指神经修复长期结果中的重要性。神经隔离研究技术是评估神经修复结果的重要辅助手段，也是评估神经缝合术后神经再生真实最终结果的唯一方法。
