自制神经束两端间距3 mm空间在腕部正中神经断裂修复中的应用

郑辉; 郝义伟; 江起庭; 谢凌寒

doi:10.11659/jjssx.07E023009

您当前的位置：

首页 >

文章列表页 >

自制神经束两端间距3 mm空间在腕部正中神经断裂修复中的应用

临床研究 | 更新时间：2024-10-22

- 自制神经束两端间距3 mm空间在腕部正中神经断裂修复中的应用
- Application of the self-made nerve bundle with 3 mm of spatial distance between the two ends in repair of median nerve rupture of the wrist
- 局解手术学杂志 2024年33卷第10期页码：919-921
- 作者机构：
  
  1.南京医科大学第四附属医院骨科，江苏南京 210000
  2.南京江北新区泰山街道社区卫生服务中心，江苏南京 210000
  3.南京江北医院手足显微外科，江苏南京 210048
- 作者简介：
  
  江起庭，E-mail：13856568108@163.com
  谢凌寒，E-mail：sherman.x@163.com
- 基金信息：
- DOI：10.11659/jjssx.07E023009
  中图分类号： R651.3
- 纸质出版日期：2024-10-25，
  
  收稿日期：2023-07-04，
- 稿件说明：
移动端阅览
郑辉,郝义伟,江起庭等.自制神经束两端间距3 mm空间在腕部正中神经断裂修复中的应用[J].局解手术学杂志,2024,33(10):919-921.

ZHENG Hui,HAO Yi-wei,JIANG Qi-ting,et al.Application of the self-made nerve bundle with 3 mm of spatial distance between the two ends in repair of median nerve rupture of the wrist[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(10):919-921.
郑辉,郝义伟,江起庭等.自制神经束两端间距3 mm空间在腕部正中神经断裂修复中的应用[J].局解手术学杂志,2024,33(10):919-921. DOI： 10.11659/jjssx.07E023009.

ZHENG Hui,HAO Yi-wei,JIANG Qi-ting,et al.Application of the self-made nerve bundle with 3 mm of spatial distance between the two ends in repair of median nerve rupture of the wrist[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(10):919-921. DOI： 10.11659/jjssx.07E023009.

摘要

目的

探讨自制神经束两端间距3 mm空间在腕部正中神经断裂修复中的应用效果。

方法

纳入2014年7月至2020年8月腕部正中神经断裂患者24例，采用自制神经束两端间距3 mm空间，然后外膜连续吻合，无神经束外露。术后石膏外固定4周，逐步加强功能锻炼。参照Burchiel疗效评价标准对正中神经恢复情况进行评价。

结果

末次随访时患者中指感觉恢复均达S4级，拇指对掌、对指功能均恢复，大鱼际肌饱满，未见萎缩。末次随访时正中神经恢复情况：优18例，良6例，优良率100%。

结论

自制神经束两端间距3 mm的神经外膜吻合，可实现精准对位，防止瘢痕压迫，避免神经瘤的发生，能有效恢复正中神经功能。

Abstract

Objective

To investigate the application effect of the self-made nerve bundle with 3 mm of spatial distance between the two ends in repair of median nerve rupture of the wrist.

Methods

A total of 24 patients with median nerve rupture of the wrist from July 2014 to August 2020 were included. The self-made nerve bundle with 3 mm of spatial distance between the two ends was applied， and then the epineurium was anastomosed continuously， and no nerve bundle was exposed. After 4 weeks of plaster external fixation， functional exercise was gradually strengthened. The median nerve recovery was evaluated according to Burchiel efficacy evaluation criteria.

Results

At the last follow-up， the sensory recovery of the middle finger reached S4 level， the functions of thumb to palm and finger to finger recovered， and the thenar eminence was full without atrophy. At the last follow-up， the median nerve recovery was excellent in 18 cases， good in 6 cases， and the excellent and good rate was 100%.

Conclusion

The epineural anastomosis of self-made nerve bundle with 3 mm of spatial distance between the two ends can achieve accurate counterpoint， prevent scar compression， avoid neuroma， and effectively restore the function of the median nerve.

关键词

正中神经神经损伤神经外膜缝合自制空间

Keywords

median nervenerve injuryepineurium sutureself-made space

references

Cogan CJ，Kandemir U. Role of peripheral nerve block in pain control for the management of acute traumatic orthopaedic injuries in the emergency department： diagnosis-based treatment guidelines［J］.Injury，2020，51（7）：1422-1425.doi：10.1016/j.injury.2020. 04.016http://dx.doi.org/10.1016/j.injury.2020.04.016.

Daly M，Langhammer C. Radial nerve injury in humeral shaft fracture［J］.Orthop Clin North Am，2022，53（2）：145-154.doi：10.1016/j.ocl.2022.01.001http://dx.doi.org/10.1016/j.ocl.2022.01.001.

Lopes B，Sousa P，Alvites R，et al. Peripheral nerve injury treatments and advances： one health perspective［J］.Int J Mol Sci，2022，23（2）：918. doi： 10.3390/ijms23020918http://dx.doi.org/10.3390/ijms23020918.

Brosius Lutz A，Lucas TA，Carson GA，et al. An RNA-sequencing transcriptome of the rodent Schwann cell response to peripheral nerve injury［J］.J Neuroinflammation，2022，19（1）：105.doi： 10.1186/s12974-022-02462-6http://dx.doi.org/10.1186/s12974-022-02462-6.

Qiu J，Boucher M，Conley G，et al. Traumatic brain injury-related optic nerve damage［J］.J Neuropathol Exp Neurol，2022，81（5）：344-355. doi： 10.1093/jnen/nlac018http://dx.doi.org/10.1093/jnen/nlac018.

Burchiel KJ，Clarke H，Haglund M，et al. Long-term efficacy of microvascular decompression in trigeminal neuralgia［J］. J Neurosurg，1988，69：35-38. doi： 10.3171/jns.1988.69.1.0035http://dx.doi.org/10.3171/jns.1988.69.1.0035.

Jamshidi A，Hasanzadeh A，Zonnour A，et al. Iatrogenic facial nerve injury in mastoidectomy： the impact of variables on the outcome［J］.Am J Otolaryngol，2022，43（4）：103472.doi：10.1016/j.amjoto. 2022.103472http://dx.doi.org/10.1016/j.amjoto.2022.103472.

Adidharma W，Khouri AN，Lee JC，et al.Sensory nerve regeneration and reinnervation in muscle following peripheral nerve injury［J］.Muscle Nerve，2022，66（4）：384-396. doi： 10.1002/mus.27661http://dx.doi.org/10.1002/mus.27661.

Lee JI，Govindappa PK，Wandling GD，et al. Traumatic peripheral nerve injury in mice［J］.J Vis Exp，2022（181）：e63551. doi： 10.3791/63551http://dx.doi.org/10.3791/63551.

周经，杨晓楠，祁左良. 复合型神经导管与周围神经修复［J］. 中华整形外科杂志，2019，35（3）： 314-318. doi：10.3969/j.issn.1673-8225.2011.08.030http://dx.doi.org/10.3969/j.issn.1673-8225.2011.08.030.

Mark LW，Michael R，Jack GG，et al. Peripheral nerve injury，scarring，and recovery［J］. Connect Tissue Res，2019，60（1）： 3-9. doi：10.1080/03008207.2018.1489381http://dx.doi.org/10.1080/03008207.2018.1489381.

Zuzana K，Rukmani S，Alan JH，et al. The use of genipin as an effective，biocompatible，anti-inflammatory cross-linking method for nerve guidance conduits［J］. Adv Biosyst，2020，14（3）： e1900212. doi：10.1002/adbi.201900212http://dx.doi.org/10.1002/adbi.201900212.

段现来，曾志成. 周围神经修复与再生研究进展［J］. 中国局解手术学杂志，2002，2（11）：167-169. doi： 10.3969/j.issn.1672-5042.2002.02.042http://dx.doi.org/10.3969/j.issn.1672-5042.2002.02.042.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

珍宝丸介导NF-κB/p65通路对脊髓损伤大鼠的神经保护作用