屈肌2区指神经修复伴指动脉损伤的远期疗效

IF 0.8 Q4 SURGERY
G. Yildiran, M. Sutcu, O. Akdağ, Z. Tosun
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引用次数: 6

摘要

目的在重建手术中,任何组织或区域的良好愈合效果都与良好的血液供应密切相关。外周神经的愈合也与血液供应密切相关。我们的目的是评估在有和没有外源性血液供应的情况下,指神经愈合是否有任何差异。方法对48例单侧指神经2区损伤患者进行临床分析。动脉损伤不可修复者24例,无动脉损伤者24例。将24例“未修复动脉组”(UA)与24例“完整动脉组”(IA)进行比较。结果平均随访时间17.7个月。IA组和UA组的平均两点辨别(2PD)分别为5.29 mm和5.37 mm。IA组1个神经瘤,UA组2个神经瘤。我们发现两组之间在神经瘤、2PD和冷不耐受方面没有统计学上的显著差异。英国医学研究理事会感觉恢复临床量表结果两组具有可比性。结论指神经的愈合与多种因素有关。我们假设血流量可能是这些因素之一;然而,在这个区域,指动脉修复并不是指神经愈合的首要决定因素。上肢损伤程度有待进一步研究。尽管结果如此,我们认为不能不修复就离开指动脉,我们建议修复动脉和神经以达到正常的解剖完整性,并保证手指在可能的未来损伤中血液流动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Long-Term Outcomes of Digital Nerve Repair Accompanied by Digital Artery Injury in Flexor Zone 2
Abstract Objectives Better healing results of any tissue or area is closely linked with a well-blood supply in reconstructive surgery. Peripheric nerve healing is closely related to blood supply as well. We aimed to assess whether there was any difference between digital nerve healing with and without extrinsic blood supply. Methods We assessed 48 patients with unilateral digital nerve injury at zone 2. Twenty-four of them had unrepairable arterial injury and other 24 had no arterial injury. The 24 patients in the “unrepaired artery group” (UA) and 24 patients in the “intact artery group” (IA) were compared. Results Mean follow-up time was 17.7 months. The mean two-point discrimination (2PD) was 5.29 mm in IA group and 5.37 mm in UA group. One neuroma in IA group and two neuromas in UA group were determined. We found no statistically significant difference between these groups in terms of neuroma, 2PD, and cold intolerance. The results of British Medical Research Council sensory recovery clinical scale were comparable for these two groups. Conclusion Digital nerve healing is related to numerous factors. We hypothesized that blood flow may be one of these factors; however, at this zone digital artery repair is not the foremost determinant for digital nerve healing. Further researches should be done for upper injury levels. Despite this result, we argue not to leave the digital artery without repairment and we propose to repair both artery and nerve to achieve the normal anatomical integrity and to warrant finger blood flow in possible future injuries.
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来源期刊
Surgery Journal
Surgery Journal SURGERY-
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64
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12 weeks
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