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

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。

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.