儿童手腕部肌腱神经损伤的治疗与康复

Treatment and Rehabilitation of Children With Traumas of Wrist Tendon Complicated with Nerve Injury

目的探讨儿童手腕部肌腱神经损伤的治疗疗效与康复。方法本组病例56例,合并神经损伤24例。经过严格清创后,尽快对断裂肌腱行改良kessler缝合,损伤神经行外膜吻合,术后树脂石膏外固定及功能锻炼。结果术后随访44例,按手功能标准进行疗效评价,优28例,良14例,差2例,优良率95.4%;随访病例中合并运动神经损伤者18例,优12例,良4例,差2例,优良率88.9%。结论对儿童手腕部肌腱断裂合并神经损伤,应尽早诊断,确定肌腱、神经损伤部位及程度,及时采用微创显微外科技术予以修复。术后合理运用药物及有效的功能锻炼,是提高其疗效的重要措施。

Objective To discuss the methods of the treatment and rehabilitation of the children with the wrist tendon traumas complicated with nerve injury.Methods 56patients were treated by open reduction and nerve exploration reconstruction at the same time (24cases of them were complicated with nerve injury).Repairing the tendon with kessler 's way and the never injuried with anastomosis of never-extima after strick debridement,the injuried hands were internal fixated with resin plaster-splint and did functional exercise after operation.Results All of44cases were followed up;Efficacy was evaluated according to the standard of hand function.28cases were excellent in traumas of tendon,14good,and2poor.The rate of excellence was95.4%.18cases were followed up in traumas of nerve;12cases of them were excellent,4good,2poor.The rate of excellence was88.9%.Conclusions The severed trauma of hand tendon complicated with nerve injury of children's hand,should early be diagnosed and identified to the injury degree of tendon and nerve in time .Repairing the tendon and nerve with the microsugical technology,using medicine and effective functional exercise are necessary after operation.All of there methods are important for raising the excellent rate of traumas of tendon complicated with nerve injury.