Polatkan S, Orhun E, Polatkan O, Nuzumlali E, Bayri O
Istanbul Hand Surgery and Microsurgery Centre, Turkey.
Microsurgery. 1998;18(3):192-6. doi: 10.1002/(sici)1098-2752(1998)18:3<192::aid-micr13>3.0.co;2-t.
In the Istanbul Hand Surgery and Microsurgery Centre, between 1991-1996, 28 out of 54 patients who had clean-cut median nerve laceration at the wrist level were evaluated in a detailed manner regarding the improvement of sensibility following primary repair. Semmes-Weinstein monofilament and vibration tests form the group of threshold tests, and static and dynamic two-point discrimination tests and the Moberg pick-up test form the group of functional tests which were applied to the patients. Follow-up was from 1 to 5 years. Moreover, subjective findings such as cold intolerance, pain, and paraesthesia were also evaluated. All the results obtained were evaluated in relation to the SO-S4 sensibility improvement criterion which Waylett-Rendall recommended. The following results were obtained: S4 in 35.7% of the patients, S3+ in 28.5%, S3 in 14.2%, S2+ in 7.14%, S2 in 10.7%, and S1 in 3.5%. In our opinion the most important reason for the high rate of success was the fact that we worked with a highly selective group of patients and the fact that there was a high rate of young patients in this group (21.4% of them were under the age of 15). It was observed that there was a significant correlation between age and functional sensibility improvement (P = 0.04). Moreover, when we observed the relation between age and Semmes-Weinstein monofilament, static two-point discrimination, and dynamic two-point discrimination tests, it was seen that age had a significant correlation with each of the parameters (r = 0.61, P = 0.001; r = 0.58, P = 0.002; r = 0.57, P = 0.002). There was a clear decline in the intensity of the paraesthesia in S3+ and S4 group (X2 = 4.7, P = 0.02) and in these groups the period of Moberg pick-up test was meaningfully short (P < 0.05).
在伊斯坦布尔手外科与显微外科中心，1991年至1996年间，对54例腕部正中神经锐器切割伤患者中的28例进行了详细评估，以观察一期修复后感觉功能的改善情况。对患者进行了Semmes-Weinstein单丝试验和振动试验等阈值测试，以及静态和动态两点辨别试验和Moberg拾物试验等功能测试。随访时间为1至5年。此外，还评估了诸如不耐寒、疼痛和感觉异常等主观症状。所有获得的结果均根据Waylett-Rendall推荐的SO-S4感觉改善标准进行评估。结果如下：35.7%的患者达到S4，28.5%达到S3+，14.2%达到S3，7.14%达到S2+，10.7%达到S2，3.5%达到S1。我们认为成功率高的最重要原因是我们选择的患者群体具有高度选择性，且该群体中年轻患者比例较高（其中21.4%年龄在15岁以下）。观察发现年龄与功能感觉改善之间存在显著相关性（P = 0.04）。此外，当观察年龄与Semmes-Weinstein单丝试验、静态两点辨别试验和动态两点辨别试验之间的关系时，发现年龄与每个参数均存在显著相关性（r = 0.61，P = 0.001；r = 0.58，P = 0.002；r = 0.57，P = 0.002）。S3+和S4组的感觉异常强度明显下降（X2 = 4.7，P = 0.02），且在这些组中Moberg拾物试验的时间明显缩短（P < 0.05）。
