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):36-40.
The purpose of this study was to measure the relationship between severity of injury and sensibility outcome. This was done by a retrospective study of 37 digital nerve repairs in 26 patients, with a mean follow-up of 35 months. All patients underwent complete hand examination and standard nerve testing, including static and moving two-point discrimination, Semmes-Weinstein monofilaments (SWMF), object recognition, and the pick-up test. A hand injury severity scoring system based on wound characteristics, mechanism of injury, and number of structures involved was then developed. Severity grading led to three classes, and each study group was well matched. Subjectively, all patients considered their outcome as either good or excellent. Objective results are reviewed individually for each test, with the overall combined result of static and moving two-point discrimination being excellent (Highet S4) in 81% for class I, 41% for class II, and 31% for class III, all different at a statistically significant level. We concluded that the severity of injury in the hand can be graded and does have a relationship to the functional end result of digital nerve repair.
本研究的目的是测量损伤严重程度与感觉功能结果之间的关系。通过对26例患者的37例指神经修复进行回顾性研究来完成此项工作，平均随访时间为35个月。所有患者均接受了全面的手部检查和标准的神经测试，包括静态和动态两点辨别觉、Semmes-Weinstein单丝检查（SWMF）、物体识别和拾物试验。然后基于伤口特征、损伤机制和受累结构数量制定了手部损伤严重程度评分系统。严重程度分级分为三类，每个研究组匹配良好。主观上，所有患者都认为其结果为良好或优秀。对每个测试的客观结果进行单独评估，静态和动态两点辨别觉的总体综合结果在I类中81%为优秀（Highet S4），II类中为41%，III类中为31%，在统计学上均有显著差异。我们得出结论，手部损伤的严重程度可以分级，并且确实与指神经修复的功能最终结果有关。
