Objective To provide the new method for repairing bilateral proper digital nerve defects.Methods From March 2010 to January 2013,17 patients with bilateral proper digital nerve defects were admitted to our center.During operation,the injured digital nerve was excised,then bilateral distal ends and proximal ends were sutured,respectively; consequently,the distal and proximal nerve bows were formed.A cutaneous antebrachii lateralis nerve was freed and obtained from the homolateral forearm,then divided equally to 2 parts which were used to bridge the 2 nerve bows.Results All the patients achieved primary healing of wound after operation,17 fingers recovered uneventfully.Postoperative follow-up interval ranged from 3.5 to 6.8 months,with an average of 4.7 months.The sensation of fingertip recovered ranged from S2 to S4 (mean S3 ) and the two point discrimination ranged from 5.2 to 8.5 mm (average,6.45 mm) in 17 cases.According to the total active movement (TAM) evaluation system introduced by the American Society for Surgery of the Hand in 1975,the results were excellent in 11 cases,good in 4 cases,and fair in 2 case,and the excellent and good rate was 88.2%.Conclusion The arched nerves of double end-to-side neuroanastomosis is valuable method for repairing bilateral proper digital nerve defects.
JIANG Qi-ting
,
WANG Yu
,
YANG Li-na
,
JIANG Zhi-wei
. Double end-to-side neuroanastomosis for repairing bilateral proper digital nerve defects[J]. Surgical Research and New Technique, 2013
, 2(4)
: 240
-242
.
DOI: 10.3969/j.issn.2095-378X.2013.04.007
[1]Jiang B,Zhang P,Zhang D,et al.Study on small gap sleeve bridging peripheral nerve injury[J].Artif Cells Blood Substit Immobil Biotechnol,2006,34(1):55-74.
[2] Zhang P,He X,Zhao F,et al.Bridging small-gap peripheral nerve defects using biodegradable chitin conduits with culturedSchwann and bone marrow stromal cells in rats[J].J Reconstr Microsurg,2005,21(8):565-571.
[3] 刘勇,侯春林,林浩东,等.静电纺纳米聚乳酸已内酮共聚物导管修复周围神经缺损的实验研究[J].中华手外科杂志,2011,27(4):227-230.
[4] 寇王辉,殷晓峰,姜保国,等.远端神经变性对神经再生放大规律的影响[J].中华显微外科杂志,2008,31(5):354-357,405.
[5] 江起庭,杨丽娜,江志伟.双端侧神经吻合修复双侧指固有神经陈旧性损伤[J].中华骨科杂志,2012,32(12):1161-1165.
[6] 江起庭,冯明生,江志伟,等.神经移植合并双端侧神经吻合治疗双侧指固有神经陈旧性损伤[J].组织工程与重建外科杂志,2011,7(6):335-337.
[7] 江起庭,杨丽娜,王钰,等.“化整为零”的理念在拇指两叶皮瓣修复拇指末节脱套伤中的应用[J].中国美容整形外科杂志,2013,24(9):527-530.
[8] 江起庭,杨丽娜,王钰,等.同指组合皮瓣修复拇指末节脱套伤34例[J].中国烧伤杂志,2013,29(6):571-572.
[9] 江起庭,冯明生,江志伟,等.同指两叶皮瓣瓦合修复手指远节脱套伤[J].中国修复重建外科杂志,2012,26(7):806-809.
[10] Ozbek S,Ozcan M,Noyan B,et al.End-to-side nerve coaptation:is an additional proximal coaptation useful when available?[J].Ann Plast Surg,2005,55(3):281-288.