上臂桡神经损伤的手术治疗

Surgical management of patients with radial nerve injury in the arm

目的 探讨上臂桡神经损伤的机制、手术时机、手术方法及其预后。方法 对 1986 0 7～ 2 0 0 1 0 6作者经治的 6 0例上臂桡神经损伤进行回顾性研究。结果 6 0例中男 42例 ,女 18例 ;年龄 12～ 5 5岁 ,平均 33 5岁。桡骨干骨折合并桡神经损伤 44例 ,锐器伤 12例 ,医源性损伤 4例。 6 0例患者中 47例获得随访 ,随访时间 6个月～ 15年 ,平均 5年 6个月 ,优 36例 (76 6 %) ,良 7例(14 9%) ,差 4例 ,优良率 91 5 %。结论 上臂桡神经损伤的最常见原因为肱骨干骨折所致 ,以挫伤多见 ,早期治疗、术中根据不同情况选择不同显微外科治疗是提高疗效的关键。

Objective To investigate the mechanism,timming of operation,surgical method and the outcome of radial nerve injury in the arm.Methods Sixty patients with radial nerve injuries were evaluated from July 1986 to June 2001.Results Among the 60 cases,42 were male and 18 were female,the age ranged from 12 to 55 years,averaged 33.5 years old.44patients with radial nerve injuries were associated with humeral shaft fracture,12 patients were sharp injury and 4 were iatrogenic injury.Forty-six patients were followed-up from 6 months to 15 years,mean 5.5 years,36out of 47(76.6%) obtained excellent result;good in 7(14.9%) and bad in4,the excellent and good rate is 91.5%.Conclusion The most common mechanism of radial nerve injury in the arm is fractures of humerus,most of which were contusion injuries.The key to affects the outcome of treament is selecting different microsurgical procedure according to the individual circumstance.