Wang W Z, Crain G M, Baylis W, Tsai T M
Christine M. Kleinert Institute for Hand and Micro Surgery, Louisville, KY, USA.
J Hand Surg Am. 1996 Jan;21(1):138-43. doi: 10.1016/s0363-5023(96)80167-5.
Evaluations of 67 adults with 90 complete digital nerve injuries were made more than 1 year after surgery. Moving and static two-point discrimination was determined on both lateral aspects of the injured and contralateral uninjured digits. Digits with primary repairs in mild crush or saw injuries had significantly worse two-point discrimination compared with digits that had a primary repair of a simple laceration. Furthermore, in mild crush injuries, digits with primary grafting had significantly better results than those with primary repair. Patients under 40 years of age had better two-point discrimination than those over 40. Some overlap innervation from the uninjured side was noted in two of eight digits tested, since sensation of the injured side was completely lost when the uninjured nerve of that digit was anesthetized. These results support the hypothesis that better recovery is obtained if tension is avoided at the nerve repair site in mild crush or saw injuries.
对67例患有90处完全性指神经损伤的成年人在术后1年多进行了评估。对受伤手指和对侧未受伤手指的两侧均测定了动态和静态两点辨别觉。与单纯裂伤一期修复的手指相比，轻度挤压伤或锯伤一期修复的手指两点辨别觉明显更差。此外，在轻度挤压伤中，一期移植的手指比一期修复的手指效果明显更好。40岁以下的患者两点辨别觉比40岁以上的患者更好。在测试的8个手指中有2个发现了来自未受伤侧的一些重叠神经支配，因为当该手指的未受伤神经被麻醉时，受伤侧的感觉完全丧失。这些结果支持这样一种假设，即在轻度挤压伤或锯伤中，如果在神经修复部位避免张力，可获得更好的恢复。
