目的介绍一种修复双侧指固有神经陈旧性损伤的方法。方法自2000年11月至2009年10月,共收治40例陈旧性双侧指固有神经损伤患者,分为A、B、C三组。A组15例,行双侧神经桥接端侧缝合;B组13例,行单侧神经桥接端侧缝合;C组12例,行神经桥接断端缝合。结果术后随访6~8个月,A组患者伤指麻木、疼痛完全消失,指腹饱满、弹性佳,感觉测定为S4~S4+级,两点分辨觉为5.0~6.0 mm;B组患者伤指感觉恢复不同步,且缝合侧感觉明显,感觉测定为S1~S3级,两点分辨觉为7.0~7.6 mm;C组患者伤指感觉测定为S3~S3+级,指腹为SI级甚至盲区,两点分辨觉为7.5~8.5 mm。结论移植神经、双端侧神经缝合对于二期修复双侧指固有神经损伤是一种可行的方法。
Objective To introduce a new method for the repair of the bilateral chronic proper digital nerve injuries.Methods From November 2000 to October 2009,40 cases with bilateral chronic proper digital nerve injuries were divided into 3 groups.Fifteen cases in Group A were conducted nerve graft with two end-to-side neurorrhaphy.Thirteen cases in Group B were conducted nerve graft with one end-to-side nerve neurorrhaphy.Twelve cases in Group C were performed nerve transplantation with end-to-end nerve anastomosis.Results After 6-8 months of follow-up,the anaesthesia and pain of the injured fingers disappeared completely and finger pulp was plump with good flexibility in group A.The measurement of the sense was S4-S4+ and 2-PD was 5.0-6.0 mm.The feeling recovery was not synchronization and the operative side felt more obvious in group B.The measurement of the sense was S1-S3 and 2-PD was 7.0~7.6 mm.In Group C,the measurement of the sense was S3-S3+,SI or even blind on the finger pulp,and 2-PD was 7.5~8.5 mm.Conclusion Nerve transplantation with end-to-side nerve anastomosis were a new valuable method for the repair of bilateral chronic proper digital nerve injuries.